/ A V-ir HOME HAND-BOOK OF THE HOME HAND-BOOK OF Domestic Hygiene AND RATIONAL MEDICINE. y By J. H. KELLOGG, M. D., MEMBER OF THE AMERICAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE, THE Cy AMERICAN PUBLIC HEALTH ASSOCIATION, THE AMERICAN SOCIETY OF MICROS- COPISTS, THE MICHIGAN STATE MEDICAL ASSOCIATION, STATE BOARD OF HEALTH OF MICHIGAN, EDITOR OF “GOOD HEALTH,” AUTHOR OF “PLAIN FACTS FOR OLD AND YOUNG,” “DIPHTHERIA,” “’J'HE HOUSEHOLD MANUAL,” “ALCOHOLIC FOISON,” AND VARIOUS OTHER WORKS ON HYGIENE AND TEMPERANCE. , « ; • 'Tv / BATTLE CREEK, MICH. GOOD HEALTH PUBLISHING COMPANY. 1880. Entered according to Act of Congress, in the year 1880, By J. H. KELLOGG, M. D., In the office of the Librarian of Congress, at Washington. ALL RIGHTS RESERVED. PREFACE. It is unnecessary to argue the importance of a work of the character which this volume is intended to possess, since the demand for popular works relating to the preservation of health and the treatment of disease has in¬ creased so greatly, particularly within the last few years, that books of no other class are in such constant and general demand, if we except the in¬ dispensable family Bible. The common people as well as the higher classes in society are coming to think and investigate for themselves on all subjects of practical importance; and it is not surprising that there should be a general and increasing interest in subjects which involve the most vital of human interests, — life and health. There can be urged no reason of real weight why men and women of intelligence should not have an opportunity to acquire knowledge on ^11 useful subjects which can be brought within their reach. This fact has been well recognized in nearly every department of science, and at the pi'esent day, thanks to the labors of such eminent scientists as Prof. Proctor, Dr. Huxley, Prof. Tyndall, Rev. James G. Wood, and numerous other workers in various scientific fields, the great storehouse of knowledge into which the accumulated wealth of. the ages has been garnered, opens its doors almost as widely and freely to the wayfaring man, the laborer, or the most humble seeker after truth, as to the professor or the savant. New scientific facts are no longer held as secrets by their dis¬ coverers, to be imparted only to those who have the opportunity of sitting at the feet of learned professors in the temples of science, but are spread before the great masses of the common people in popular language, thus making each new acquisition to scientific knowledge the common property of the civilized portion of the race. The pioneers in this noble work of elevating the masses by sharing with them the golden treasures of scientific lore have not accomplished these grand results without opposition, oftentimes most bitter and unrelenting, from many men of equal rank with themselves as philosophers and scientists. It has been urged that science would lose some¬ what of its dignity if its truths were cheapened by popularization. The ex¬ periment has been tried, however, and the result is in the most eminent degree satisfactoiy. Science has lost some of its mystery, but has gained (i) 11 PREFACE. the confidence of thousands who before looked upon its choicest truths as the most monstrous vagaries. The science of medicine has been passing through this same ordeal. Medical scientists are of all classes of scientific workers the most conserva¬ tive. The wonderful revolutions which have overturned the fossil theories carefully hoarded in other departments of scientific research, and established new and better theories, have affected medicine much less than other branches, and hence we find many still clinging to notions which originated in an age when learning of all kinds was yet in a most primitive state ; and one of these is the notion that the common people have no business with medical knowledge. We are glad to know that the adherents of this view are con¬ stantly decreasing. The more advanced and liberal class of thinkers in the profession are taking the same ground with reference to medicine that has already been very generally conceded for other departments of science ; viz., that every human being has a perfect right to acquire every atom of knowl¬ edge that he is capable of comprehending. It seems to us to be true be¬ yond all questioir that every human being has at least the right to know all about himself ; and of all classes of knowledge none is so important as that which relates to the preservation of human life and the alleviation of human suffering. The people have ever manifested an eagerness to obtain information on subjects of the character treated of in this vojpme, which fact has been seized upon by charlatans and made a source of pecuniary profit through the sale of worse than worthless trash, on various medical topics, which has been sown broadcast over the country. Every newspaper teems with advertise¬ ments of medical pamphlets and books on special subjects for sale or to give away, which are simply adroit means of advertising the authors, whose igno¬ rance is only equaled by their impudence and mendacity. The evil results arising from the wide dissemination of this kind of popular medical liter¬ ature has undoubtedly been one of the great causes of the deep prejudice ex¬ isting in the minds of many eminent physicians against the popularization of medical facts ; but this is really a most powerful reason for the pro¬ duction of a better class of literature to supply the existing demand, and to counteract the influence of the shameless pretensions of ignorant quacks and scheming charlatans. It has also been objected to works of this character that they are likely to do harm by teaching people to rely upon themselves instead of calling in a phy¬ sician when professional services are really required. HoAvever true this may be of some popular treatises on disease and medication, it is certainly no part of the object of this work to in any way detract from the dignity or usefulness of the profession of which we are proud in being a member. PREFACE. ill In fact, tlie very contrary lias been one of our chief aims in the production of this work. We may present the following as the principal objects which we have had in view in the preparation of this volume : — 1. To present in a popular and condensed form the latest and most relia¬ ble information on the subjects of Anatomy, Physiology, and Hygiene. Con¬ siderable space has been devoted to the description of the structure and func¬ tions of the various organs of the body, a. Because these subjects lie at the very foundation of all scientific medical knowledge ; b. Because they have been universally neglected in works of a similar character. 2. To call especial attention to the causes of disease and the best means of prevention. It is universally admitted at the present time that prevent¬ ive medicine is of far greater importance than curative medication, and many of the most eminent members of the profession are devoting themselves ex¬ clusively to this branch. It has been attempted to make this work the most complete on this subject of any popular Treatise published. 3. To supply information respecting simple measures of treatment that can be employed by persons of ordinary intelligence in the absence of a • physician, when a physician cannot be obtained at once, or need not be called, as in cases of accidents and simple diseases or injuries which require only good nursing and the employment of simple remedies ; and also to render people competent to second the efforts of a wise physician in alleviating suf¬ fering and combating the fatal tendencies of disease. 4. To impress the importance of giving prompt attention to the first de¬ partures from health, and by controlling small beginnings to prevent the in¬ roads which result from a neglect of the employment of prompt and efficient measures. 5. To give a sufficiently clear outline of the nature of disease and of the most approved methods of treatment to enable the reader to discriminate be¬ tween the wise and reliable physician and the charlatan. How well we have succeeded in accomplishing the objects sought, we must leave the reader to decide. No pains or expense has been spared to make the work all that could be desired in a hand-book of this sort ; and the present volume is the result of several years of research and earnest labor. The methods of treatment suggested are such as are recommended by the most eminent and scientific members of the profession, and such as we have found effective in our own experience. If it be remarked that drugs are recommended less frequently as remedies than in most similar works, we would say that we do not approve of the cus¬ tom of making an apothecary shop of the stomach by dosing for every trifling ailment of any part of the body. In our opinion, the use and pre¬ scription of drug remedies should be left almost exclusively to the family IV THE FACE. physician. Much more harm than good results from their domestic use. The design of this hook is not to displace the intelligent, careful physician, but to aid him in his philanthropic work, and to displace, so far as possible, the vast amount of worthless medical literature with which mercenary quacks have flooded the land. We are specially indebted to our friend Dr. H. B. Baker, Secretary of the State Board of Health of Michigan, for kindness shown in revising the proofs of the sections on “ Water,” “ Hygiene of the Air,” and “ Diseased Foods,” and for several valuable suggestions. We are also under obligations to Dr. B. C. Kedzie, Prof, of Chemistry in the State Agricultural College of Michigan and President of the State Board of Health, for revision of the proof-sheets of the section on “ Adulterations of Foods and Drinks,” and for several important suggestions which have enhanced the value of that portion of the book. For many of the original illustrations which embellish the pages of the work we are largely indebted to the artistic skill of our friend and colleague, Dr. W. J. Fairfield, who has unselfishly devoted nearly all his leisure mo¬ ments for many months in making designs, drawings, and engravings for use in the work, besides relieving us of many burdens which would otherwise have gi'eatly delayed the completion of the work. Lastly, we would acknowledge our great indebtedness for the means of making this work a useful one, if it shall prove to be such, to the long list of eminent medical authors, too numerous to mention here, whose works we have consulted, and especially to the kindness of the librarian of the great medical library of the Army and Navy Medical Museum, at Washington, D. C., who gave us free access to the vast amount of valuable material there collected, embodying all the latest discoveries and improvements in the science and art of medicine up to the present date, and of Mr. Apel, the em¬ inent linguist employed in the office of the Surgeon General as an intei'- preter and translator, who rendered us invaluable aid in acquainting our¬ self with the results of the researches of eminent medical authorities in va¬ rious continental European countries. We now commit this volume, the result of several years’ labor, to those into whose hands it may fall, believing that whatever of merit it possesses will be duly recognized and appreciated, and hoping that its faults will be faithfully pointed out for correction in future editions. AUTHOR. Battle Creek, Aug. 23, 1S80. CONTENTS. ANATOMY, PHYSIOLOGY, AND HYGIENE. Definitions. — Anatomy — Physiology — Hygiene — Man’s place in nature — The constitution of matter — Matter the basis of existence — The nature of matter — Force and atoms — Organization — Low¬ est forms of life — The basis of life — The scale of being — How protoplasm works — Differences between inorganic and organized matter — Animals and vegetables — Distinctions between man and beast — What is right, and what is wrong? . 25—37 General Anatomy, or Histology. — How a human machine is built — The anatomical elements — White fibrous tissue — Yellow clastic tis¬ sue — Connective tissue — Adipose tissue — Cartilage tissue — Osse¬ ous or bony tissue — Muscular tissue — Nerve tissue — Membranes — A general view of the human mechanism . 38-49 The Bones. — Structure of bones — The joints — Varieties of joints — Di¬ visions of the skeleton — Bones of the head — The skull — Bones of the face — Bones of the trunk — The vertebrae — The thorax — The ribs — The sternum — The pelvis — The hyoid bone — Bones of the upper extremities — The scapula — The clavicle — The arm — The fore-arm — The hand — The inferior extremities— The thigh — The leg — The foot — The sesamoid bones — The wormian bones — Bones of the ear — Physiology of the bones — Support — Protec¬ tion — Motion — Possible function of the bones — Composition of the bones — Hygiene of the bones — Proper development — Im¬ proper food — Spinal curvatures — Deformity from tight-lacing — Abuse of the feet . 50-75 The Muscles.— Two kinds of muscles — The tendons — Form and ar¬ rangement of muscles — Names and action of special muscles — Muscles of the head — The occipito-frontalis — The corrugator supercilii — Orbicularis palpebrarum — Auricular muscles — Mus¬ cles of the nose — Muscles of the mouth — Muscles of ex¬ pression — Muscles of mastication — Internal muscles of the eye — Internal ear muscles — Muscles of the neck — Muscles of the trunk — Muscles within the trunk — Muscles of the upper ex- (v) VI CONTEXTS. tremities — Muscles of the wrist — Muscles of the thumb and fin¬ gers — Muscles of the lower extremities — Muscles of the thigh — Muscles of the leg — Muscles of the foot — Physiology of the muscles — How a muscle contracts — Mechanical action of muscles — Uses of muscles — Locomotion — Manual motion — Speaking — Muscular action in respiration — Muscular action in digestion — Muscular action in the circulation of the blood — Relation of mus¬ cles and nerves — Fatigue — Muscular electricity — Muscular sense — Rigor mortis — Hygiene of the muscular system — Effect of dis¬ use of muscles — How to take exercise — Rest time to exercise — Kind of exercise to be taken — Deficient exercise by students — Over-training — Necessity for unrestrained action — Evils of tight- lacing and corset- wearing — Elastics — Pull-backs, low shoulders, etc. — Tight shoes — Bad positions — Bad positions in sleeping- improper attitudes in sitting — Bad positions in standing — How to walk — Relation of food to the muscles . 7 6-1 1 5 The Nervous System. — Anatomy of the brain and nerves — Structure of nerve tissue — Divisions of the nervous system — Description of the cerebro-spinal system — Structure of the brain — The spinal cord — The cerebro-spinal nerves — The sympathetic or organic system of nerves — General properties of nerves — Physiology of the brain and nerves — Functions of the medulla oblongata — Functions of the pons and optic lobes — Functions of the cerebellum — Functions of the central ganglia — Functions of the cerebrum — The functions of the spinal cord — Functions of the spinal nerves — Functions of the cranial nerves — Functions of the sympathetic system — The mind — The mechanism of thought — The will — Memory — Blush¬ ing — Pain and its uses — Sleep — Somnambulism — Mesmerism — Animal magnetism — Mind-reading — Phrenology — Hygiene of the brain and nerves — Necessity for mental exercise — Proper mode of developing the minds of children — School cramming — Unsymmetrical mental development — Evils of excessive brain- labor — Pernicious effects of stimulants and narcotics . 116-165 The Organs of Special Sense. — The skin — The sense of touch — The muscular sense — The sense of temperature — The sense of taste — Taste aided by other senses — The uses of taste — Electrical excitement of the sense of taste — The organs of smell — L'ses of the sense of smell — Hearing: the auditory sense — The external ear — The middle ear — The ear-bones — The internal ear — Physiology of the ear — The nature of sound — How we hear — The musical in¬ strument of the ear — The accommodation of hearing — L’se of the CONTENTS. Vll Eustachian tube — Source of the power of maintaining equi¬ librium — How direction of sounds is determined — Interesting facts about the sense of bearing — The eye and its functions — The orbit — The eyelids — The lachrymal apparatus — The eyeball — The iris — The ciliary muscle — The retina — The crystalline lens — The aqueous humor — The vitreous humor — The physiology of the eye — Properties of light — Properties of lenses — How we see — Accommodation of the eye — Visual judgments — Judgment of distance and size — Judgment of solidity — Curious facts about the sense of sight — After-images — The blind spot — Contrast — Hy¬ giene of the special senses — The law of use and abuse — Evils of excessive stimulation of the senses— Hygiene of the eye — Com¬ mon neglect of the eye — Tobacco a cause of eye disease — Effects of poor light — A cause of near-sightedness — Hygiene of the ears — Danger of meddling with the ears — Danger of boxing the ears — Taking cold in the ears — Exposures of the ears . 166-201 The Circulatory Apparatus. — The heart — Valves of the heart — The pericardium— The blood-vessels — Names of some of the principal arteries — The capillaries — The veins — Action of the heart — Heart sounds — Amount of work done by the heart — The pulse — Frequency of the pulse — The course of the blood in the circu¬ lation — The systemic circulation — The pulmonary circulation— The portal circulation — Forces of the circulation — The heart — The arteries — The capillaries — The muscles and the valves of the veins — Heat — The lungs — Regulation of the circulation — Reg¬ ulation of local blood supply — The blood — Composition of the blood — White blood corpuscles — The red blood corpuscles — The liquid portion of the blood — Eunctions of the blood — Function of the white blood corpuscles — Function of the red blood corpuscles — An interesting sight — The lymphatics — Functions of the lym¬ phatics — Hygiene of the circulation — Exercise necessary for a healthy circulation — Dangers of excessive exercise — Proper clothing essential to healthful circulation — Evil effects of con¬ striction — Effects of food on the circulation — Injurious effects of cold — Evil effects of heat . 202-230 The Respiratory Apparatus. — The air-passages — The lungs — Physi¬ ology of respiration — Movements of respiration — Frequency of respiration — Coughing, sneezing, laughing, and other modifica¬ tions of respiration — Capacity of the lungs — Vital capacity — Composition of the air — Changes in the air during respiration — Changes in the blood in respiration — Respiration of the skin — vm CONTENTS. Hygiene of respiration — Lung exercise — The spirometer — Corset choking — Poisonous character of air which has been breathed — Rapidity with which the air is contaminated, by breathing — The effects of breathing impure air . 231-245 The Digestive Apparatus. — The alimentary canal — The mouth — The teeth — The milk teeth — The permanent teeth — The oesophagus — The stomach — The small intestine — The liver and pancreas — The colon — The digestive juices — The saliva — The gastric juice — The pancreatic juice — The bile — The intestinal juice — The physiology of digestion — The chemistry of digestion — The ele¬ ments of food — Action of the saliva — Action of the gastric juice — Action of the bile — Action of the pancreatic juice — Action of the intestinal juice — Review of the action of the digestive juices — The digestive process — Mastication — Insalivation — Stomach digestion — Intestinal digestion — Absorption — Oxygenation — Nervous relations — Vomiting — Hygiene of digestion — Hasty eating — Drinking at meals— Eating too frequently — Eating be¬ tween meals — Irregularity of meals — The proper number of meals — Eating when tired — Sleeping after meals — Late suppers — Too many varieties of food — Hot and cold bathing after meals — Er¬ rors in quantity of food — Overeating — Eating too little — How much should a person eat? — Deficient food elements — The quality of food — Bad cookery — Fried food — Uncooked food — Decayed food — Soft food — Too abundant use of fats — The use of sugar in excess — Condiments — Pickles — Vinegar — Tea and coffee — Alco¬ hol — Tobacco — Hard water — Alkalies — Perverted appetites — Adulterations of food — Unseasonable diet — Pressure upon the stomach — Drugs — Neglect of the bowels — Mental influence — Hy¬ giene of the teeth . 246-299 Secretion and Excretion. — Secretions — Excretions — The skin — The sweat glands — The hair — Sudden blanching of the hair — The sebaceous glands — The nails — Functions of the skin — Clean¬ liness — How to make the skin healthy— Bathing protects against colds — Aristocratic vermin — Bathing, a natural instinct — Clothing — Essential qualifications of clothing — False hair and hair dyes — The kidneys — The liver — The bile — The spleen — Other blood glands — Animal heat . 300-315 Reproduction. — Simplest form of generation — Sex — Hermaphrodism — Sex in plants — Sex in animals — Other sexual differences — Men and women differ in form — The male and the female brain — Vital organs of man and woman — The reproductive elements — Sexual organs of CONTENTS. ix plants — Sexual organs of animals — The ovum — Fecundation — Fe¬ cundation in flowers — Modes of fecundation in animals — Devel¬ opment — Unprotected development — Development in the higher animals and man — The uterus — Uterine gestation — The primi¬ tive trace— Curious relation to lower animals— Simplicity of early structures — The stages of growth — Duration of gestation — -Uter¬ ine life — How the unborn infant breathes — Parturition— Changes in the child at birth — Nursing — Puberty — Influence of diet on puberty — Premature development occasions early decay — Changes which occur at puberty— Menstruation — Nature of menstruation — Important hints — Custom of Indian women — Extra uterine pregnancy — Twins— Monsters — Hybrids — Law of sex — Hered¬ ity — Ante-natal influences — Sexual hygiene — Sexual precocity — Chastity — Mental unchastity — Early causes — Diet vs. chastity — - Tobacco and vice — Bad books — Unthought-of excesses — Conti¬ nence not injurious — Does not produce impotence — Difficulty of continence — Helps to continence — The will— Diet — Exercise — Bathing — Keligion — Sexual crimes — Criminal abortion — Secret vice — Evil associations — The evil underestimated . 316-360 I FOOD AND DIET. Definition of food — Classification of food — Albuminous elements ^ — Starch and sugar — Fats — Inorganic elements — Food elements not food — Food substances — Table of nutritive value of vari¬ ous articles of food — Proper proportion of the various elements — Table showing proportion of nitrogenous to carbonaceous elements in various foods — Table of combined foods — Table showing quantity of various foods necessary to furnish the required daily amount of nitrogenous elements — Popular errors relating to diet — It is an error to suppose that the appetite is always a correct crite¬ rion of the quality and quantity of food— It is an error to sup¬ pose that sick persons whose appetites are poor should be tempted to eat with tidbits and dainties — It is an error to suppose that children especially need large quantities of fat and sugar — It is an error to suppose that many varieties of food are essential to good digestion or nutrition — It is a very great error to suppose that brain-workers, students, clergymen, lawyers, and other persons whose vocation is largely sedentary, require but lit¬ tle food — It is an error to suppose that fish or any other single article of diet is brain food, muscle food, or food for any particu¬ lar part of the system — It is an error to suppose that people suf- X CONTENTS. fcring with nervous debility, neurasthenia, or other forms of nervous weakness, need large quantities of flesh food— It is a most erroneous notion that “ rich food ” is strengthening — It is an er¬ ror to suppose that persons engaged in laborious occupations re¬ quire a large amount of flesh food — It is an error to suppose that the system is better supported by meals at very frequent intervals than by food taken in accordance with the known time required for digestion — It is an error to suppose that the best preparation and support for extraordinary exertion is increasing the amount of food eaten proportionately — Vegetable and animal food — Testi¬ mony of eminent men — Lehman’s experiments — Dietetic impor¬ tance of meat overestimated — Meat a stimulant — Animal diet of Icelanders and its effects — Raw meat diet of the Abyssinians — Vegetable diet of the Mexicans — Cannibalism — Diseased foods — Origin of tape-worm — The trichinae — The liver fluke — The lung parasite — Bilious beasts — Parasites in wild game — Effect on ani¬ mals of abuse and violent exertion before slaughtering — Diseased and poisoned milk — Effect of diet upon meat, milk, and othei animal foods — Diseased vegetable foods — Pellagra — Rust, red-rag, or red-gum — Smut bolls, or pepper brand — Animal parasites — The meal-mite — The sugar-mite — Decayed food — Rotten cheese — Yeast and mold — Stale vegetables . 361-414 Adulterations of Foods and Drinks. — Modes of adulteration — Bread — Detection of alum in bread — To detect blue vitriol in bread — Flour — Butter — Milk — Sugar — Sirup — Test for iron — Test for sulphuric acid — Adulterated and artificial honey — Candy — Adul¬ teration of baking powders — Cheese — Canned fruits and veg¬ etables — Preserves, marmalade, etc. — Jellies — Fruit extracts — " Canned and potted meats — Vinegar and pickles — Lemon and lime juice — Tea and coffee — Adulteration of coffee, and modes of detection — Cayenne pepper — Artificial cider — Adulteration of tin — Poisoning from fruit-jars — Lead glazing — Accidental poisoning of water with zinc and lead . 415-432 WATER: ITS USES, AND DANGERS FROM CONTAMINATION. The hygienic value of water — Thirst — Regulation of tempera¬ ture — Depuration — Proportion of water in 1000 parts of various tissues — Composition of water — Pure water — Hard water — Is hard water wholesome ? — How to soften hard water — Organic im¬ purities in water — How to detect bad water — The fermentation CONTENTS. xi test — Permanganate of potash test — Suspended impurities — Im¬ pure ice — The purification of water — To remove turbidity — To re¬ move organic matter, color, and foul gases — Filtration — Care of filters — The best water . 432-450 STIMULANTS AND NARCOTICS. Alcoholic beverages — Wine — Beer — Cider — Alcohol — Gin — Whisky — Rum — Brandy — Pulque — Chica — Palm-wine, or toddy — Milk-beer, or koumiss — Arrack — Narcotics — Tobacco — Opium — Tea, coffee, cocoa, and chocolate — Mat6, or Paraguay tea — Indian hemp, or hashish — Lettuce — Hops — The Betel nut — Cocculus Indicus and sweet gale — Stramonium — Abysinthe 451-455 Alcoholic Beverages. — Evil effects of alcohol — Effects of alcohol defi¬ nite and constant — Alcohol an irritant — Alcohol is a narcotic — Alcohol destroys the blood — Effects of alcohol on the heart — The whisky flush — Alcohol lessens muscular strength — Alcohol decreases animal heat — Alcohol as a cause of disease — Drunk¬ ards’ dyspepsia — Numerous functional diseases — Organic diseases induced by alcohol — The drunkard’s heart — Alcohol a cause of apoplexy — Alcoholic consumption — The gin liver — Alcohol a cause of kidney disease — Alcoholic insomnia — Nervous disor¬ ders of drinkers — Alcoholic insanity and idiocy — Alcohol pre¬ disposes to disease — The use of alcohol decreases longevity — Effects of moderate drinking — Hereditary effects of alcohol — Ef¬ fects of alcohol on the character — Adulteration of alcohol — The medical use of alcohol — Medical properties of alcohol — The vital instincts treat alcohol as a poison — Does change of name change properties ? — Does alcohol supply force ? — Is alcohol useful as a stimulant? — Does alcohol prevent waste? — Will alcohol prevent consumption ? — Medicinal use of alcohol leads to drunkenness — The medical use of alcohol an ally of in¬ temperance — Alcohol in delirium tremens — Alcohol for mothers — What does experience prove ? — Arguments in favor of alcohol considered — 1. Alcohol is food — 2. Alcoholic beverages preserve the body — 3. Alcohol strengthens the muscles — 4. Alcohol warms the body — 5. Alcohol protects against excessive heat — G. Alcohol stimulates — 7. Alcoholic drinks protect the system against disease — 8. Alcohol aids digestion — 9. Alcohol is made from grain — 10. Whisky does not hurt me — 11. Pure liquor is not bad — 12. Moderate drinking not harmful — 13. Doctors recommend wine and brandy — 14. Scientific men recommend the CONTEXTS. xii use of alcohol — 15. All nations use stimulants — 16. The use and sale of alcoholic liquors is a source of great revenue to the gov¬ ernment — 17. The moderate use of wine is necessary to maintain nervous activity in old age — 18. Alcohol drives away dull care — 19. Alcohol increases mental power — 20. Alcohol is a good med¬ icine ; and if it will make a man well when sick, will it not keep him well? — 21. The Bible sanctions the use of wine — Two kinds of wine recognized in the Bible — Unintoxicating wine — Intox¬ icating wine — Scriptural distinctions of wines — Yayin — Shekar — Tirosh — The causes of intemperance — Tea and coffee encour¬ age drunkenness — The cure of intemperance . 456-505 Tobacco and Tobacco-Using. — Origin of the habit — The nature of to¬ bacco — Poisonous effects of tobacco — Why all smokers do not die of tobacco-poisoning — Effect of tobacco on the blood — To¬ bacco predisposes to disease — Smokers’ sore throat — Tobacco and consumption — Tobacco a cause of heart-disease — Tobacco and dyspepsia — Tobacco a cause of cancer — Tobacco paralysis — Nerv¬ ousness from tobacco — Hereditary effects of tobacco-using — Moral effects of tobacco-using — Apologies for tobacco-using considered. 506-518 The Tea and Coffee Habit. — Tea — Coffee — Chocolate — Cocoa — Mate — History of the use of tea and coffee — Effects of theine upon man and lower animals — Evil effects of using tea and coffee — 1. They waste vital force — 2. Tea and coffee injure digestion — 3. The use of tea and coffee affects injuriously the nervous system — Moral effects — Tea-drinkers’ disorder — Arguments in favor of tea and coffee considered — Tea and coffee sustain the strength — Tea and coffee soothe the nerves — Tea and coffee assist digestion — Tea and coffee relieve headache — Tea and coffee supply the place of food — Tea and coffee increase mental vigor — Tea and coffee cor¬ rect the injurious effects of poor water — Tea and coffee are neces¬ sary condiments — Tea and coffee are substitutes for food — Tea “cheers and not inebriates” . 519-536 The Opium Habit. — Enormous doses taken — Narcotic nostrums — Causes of the habit — Effects of the opium habit — Tyranny of the habit — Absinthe, chloral, ether, etc . 536-538 'HYGIENE OF THE AIK The atmosphere — Impurities of the air — Carbonic acid gas — Test for carbonic acid — Carbonic oxide — Sulphureted hydrogen — Ammonia — Sulphuric acid — Disease germs — Dust Xlll CONTENTS. — Organic poison — Various sources of dangerous gases and disease germs — Cellars — Moldy walls — Privies — Barn-vards, hen¬ coops, etc. — Drains and cesspools — Decaying wood — Feather-beds and soiled clothing — Arsenical papers — Ventilation — Plans of ventilation — Window ventilation — Evils of window ventilation — Chimney ventilation — Ventilating shafts — Heating — Moistening of the air — Night air — Disinfection — Dry earth — Lime — Pulver¬ ized charcoal — Chloride of lime — Chlorine gas — Sulphurous acid — Copperas — Permanganate of potash — Ozone . 53‘J-5S0 RATIONAL REMEDIES FOR DISEASE, Bational remedies — What is disease ? — The medical pathies — The artificial method — Exclusive method — The expectant method — Rational medicine — Nature alone possesses power to heal — Any agent which will assist nature in effecting a cure is a reme¬ dial agent, and may, under proper circumstances, be used as such — Remedial agents affect the system beneficially not through their operations upon it, but through the reactions of the living tissue upon them — All remedial agents involve in their action an expenditure of the vitality of the patient — The best remedies are those which will furnish the most remedial aid with the least ex¬ pense to the vitality of the patient — Patients, not diseases, are to be treated— There is in nature no antidote for the results of the transgression of physical laws— Therapeutic agents or remedies for disease — Hygienic agents — Water — The physiological effects of water — Water as a diluent — The effects of the solvent proper¬ ties of water — a. An increase of the urinary excretion — b. An in¬ crease in the cutaneous excretion — c. An increase in the action of the liver — cl. Increased action of the intestinal mucous mem¬ brane — Effects resulting from the modification of temperature — The cold bath — Effect of cold upon the pulse— Effect of cold upon temperature — Rationale of effects of the cold bath — The hot bath - — Rationale of effects of the hot bath — The warm bath — Sympa¬ thetic effects— Modes of administration — Remedial properties of water, or hydro-therapeutics — Water as a refrigerant — Water as a tonic — Sedative effects of water — Antispasmodic — Water as an anodyne — Water as an anesthetic — Styptic effects of water — Water as a dissolvent — Eliminative effects of water — Laxative — - Emetic — Alterative — Derivative — History of hydro-therapeutics —The bath in Egypt— Bathing among the Jews — Persian baths — The bath among the Greeks — Roman baths — Testimony of I xiv CONTENTS. Arabian physicians — Modern bathing customs — Modern medical use of water — Testimony of eminent physicians — Errors in the use of water — Heroic treatment — Crises — Hydropathic quacks — Ignorance — A popular error — Absurd claims — Neglect of other remedies — Rational hydropathy — Applications of water — 1. Equalization of the circulation — 2. Regulation of temperature— 3. Removal of pain — 4. To excite activity — 5. Removal of obstruc¬ tions — 6. Dilution of the blood — 7. Influence on the nervous system — Temperature of baths — How to determine the temperature of a bath without a thermometer — Another method — Rules for bath¬ ing and the administration of baths — General applications — Swim¬ ming — Plunge bath — Sponge bath — Rubbing wet-sheet — Wet- sheet pack — Shower pack — Dry-sheet pack — Sweating pack — Full bath — Half bath — Shallow bath — Affusion — Pail douche — The cataract douche — Hose douche — Shower bath — Spray bath — Vapor bath — The Russian bath — Local applications — Sitz bath — • Leg bath — Foot bath — Half pack — Chest pack — Leg pack — Chest wrapper — Wet girdle — Ascending douche — Drop bath — Arm bath — Head bath — Eye bath — Ear bath — Nasal douche — Post¬ nasal douche — The uterine douche — Enema — Compresses — Fo¬ mentations — Applications of ice — Water drinking — Water emetic — Local applications of vapor — Applications of water in surgery — Miscellaneous baths — Sea-bathing— Mineral-water baths — The oil bath, or inunction — Novel baths — The milk bath — Mud bath — Earth bath — Therapeutical applications of temperature — Applica¬ tions of heat — The Turkish bath — Hot-air bath — Local applica¬ tions of dry heat — Applications of cold — Freezing — Aerotherapy, or remedial applications of air — Air bath — The use of com¬ pressed or rarefied air — Sunlight and insolation — Use of the concentrated solar rays — Ancient use of the sun bath — Electricity — Galvanic electricity — Faradic electricity — To prepare the ap¬ paratus for use — To distinguish the poles — To take care of the apparatus — Methods of modifying the current — Conducting wires — Electrodes — The effects of electricity — General faradiza¬ tion — Local faradization — The electric bath — Electro-vapor bath — Thermo-electric bath — Various combinations of electricity with water — Other electric appliances — Surgical uses of electricity - — Medical gymnastics or Swedish movements — The remedial value of movements — To regulate the circulation — To increase secre¬ tion and excretion — To increase respiratory power — To increase digestive power — To increase assimilation — To increase vital ac- CONTENTS. xv tion — To regulate muscular action — General principles governing the application of movements — Description of various move¬ ments — Movements to develop the muscles of the trunk — Mis¬ cellaneous movements — Passive and active-passive movements — Pulling movements — Kneading — Stroking — Clapping — Chop¬ ping — Knocking — Sawing — Vibration — Percussion — Massage — Muscle beating — Lung gymnastics — Mental therapeutics — Im¬ portance of employing mental therapeutics . 581-727 Medical Dietetics. — Meat, or flesh-food — Fats — Milk — Vegetables — Grains — F ruits — Sugar — Salt — Condimen ts — Drinks — Absti¬ nence from food — Digestibility of foods — Articles easy of diges¬ tion — Articles not easy of digestion — Indigestible articles — Nutri¬ tive injections — Meat solution — Pancreas and meat soldtion — Pancreas and cream — Beef tea and egg — Useful dietetic recipes — Milk and lime-water — Bran tea — Bran or wheat coffee — Acorn coffee — Water gruel — Milk gruel — Oatmeal gruel — Bice gruel — Milk porridge — Bice and apples — Bice blanc-mange — Arrow- root blanc-mange — Egg-nog — White of egg and milk — White of egg — Beef tea — Another method — Flaxseed tea — Barley water — Currant-jelly water — Apple water — Toast water — Lemonade — Ilot lemonade — Sago jelly — Bread jelly — Tapioca jelly — Gum arabic water — Diabetic bread No. 1. — Diabetic bread No. 2 . 727-743 Medicinal Agents and Miscellaneous Remedies. — Tonics — Strych¬ nia — Mineral tonics — Heart stimulants — Ammonia — Alcohol — Digitalis — Heart sedatives — Antimony — Citric acid — Arnica — Prussic acid — Antispasmodics — Assafetida — Lactucarium — Coffee — Anodynes — Morphia — Belladonna — Hvosciamus and stramonium — Anesthetics — Chloroform — Ether — Nitrous oxide — Bi-chloride of methyl — Depresso-motors — Calabar bean — The bromides — Hydrate of chloral — Nitrite of amyl — Lobelia — Tobacco — Gelsemium — Alteratives — Arsenic — Mercury — Iodine — Iodide of potash — Iodoform — Cod-liver oil — Phosphoric acid — Colchicum — Sarsaparilla — Sassafras, taraxacum, etc. — Local remedies — Astringents — Alum — Sulphate of aluminum — Lead — Bismuth — Apomorphia — Mustard flour — Tartar emetic — Sulphate of zinc — Cathartics — Laxative food — Manna — Car¬ bonate of magnesia — Sulphur — The enema — Diuretics — Dia¬ phoretics — Expectorants — Emmenagogues — Oxytocics — Epi- spastics and rubefacients — Counter-irritation — Escharotics — Caustic potash — Vienna paste — Arsenic — Nitric acid — An¬ thelmintics — Senna — Spigelia — Koosso — Male fern — Pomegran- XVI CONTENTS. ate rind — Miscellaneous remedies — Pepsin — Dry cupping — Charcoal — Poultices — Bread and milk poultice — Bread and water poultice — Bran poultice — Indian meal mush poultice — Starch poultice — Slippery elm poultice — Linseed meal poultice — Char¬ coal poultice — Egg and alum poultice — Mustard poultice or plas¬ ter — Carrot and turnip poultices — Gargles — Alum gargle — Lime gargle — Chlorate of potash gargle — Brandy and water gar¬ gle — Permanganate of potash gargle — Carbolic acid gargle — Chlorine solutions — Lotions — Alcohol wash — Vinegar wash — - Wash for fetid feet — Wash for sore mouth and chapped hands — Borax wash — Wash for hands — Face-wash — To remove tan, clear the skin, etc. — Lotions for dandruff — Eye-washes — Lini¬ ments— Camphor Liniment — Ammonia liniment — Lime liniment — Chloroform liniment — Unguents, or ointments — Vaseline oint¬ ment — Cocoanut oil — Carbolic acid ointment — Itch ointments — • Ointments for sunburn — Inhalations — Oxygen — Ozone — Water — Vinegar — Lime — Carbolic acid — Balsam of Tolu — Glycerine — Glycerine and tannin — Gum arabic — Salt — Chlorinated soda — Permanganate of potash — Tar — Adhesive plasters — Decoc¬ tions — Blackberry -root tea — Tea of white-oak bark — Tooth powders — Medicated baths — Bran bath — Gelatine bath — Alkaline bath — Soap bath — Salt bath — Mustard bath — [Medicated fo¬ mentations — Sulpho-vapor bath — Glycerine bath — Salt-rubbing bath — The hot-air and vapor douche — Lime-water — To remove stains produced by nitrate of silver and iodine . 743-810 DESCRIPTION OF DISEASES AND THEIR TREATMENT. Structural derangements — Morbid conditions of the blood and other fluids — Diseased conditions of the solid structures of the body — Degenerations and morbid growths — Functional derange¬ ments — Irritation — Congestion — Inflammation — Depression — Fever — Causes of disease — Predisposing causes of disease — Symptoms of disease — Diagnosis — Prognosis — General principles of treatment . 811-825 General Diseases. — Irritation — Congestion — Depression— Inflammation 825-836 General Diseases of Nutrition. — Anaemia — Acute Anaemia — Chronic Anaemia — Chlorosis — Plethora — Obesity or corpulence — Scrofula or king’s evil — Hemorrhagic diathesis, or haemophilia — Scurvy — Diabetes mellitus, or true diabetes — Diabetes insipidis . 837-871 XVII CONTENTS. Diseases of the Digestive Organs. — Diseases of the mouth— Catarrh of the mouth — Aphthae — Cancrum oris, diphtheritic inflamma¬ tion of the mouth, or canker of the mouth — Ulcers of the mouth — Thrush or muguet — Inflammation of the tongue, glossitis — • Gangrenous sore mouth, or noma — Salivation — Pharyngitis, clergyman’s sore throat — Quinsy, tonsilitis — Enlarged tonsils — - Diseases of the oesophagus — Inflammation and ulceration of the oesophagus — Stricture of the oesophagus — Dilatation of the oesophagus — Morbid growths — Nervous diseases of the oesopha¬ gus — Paralysis of the oesophagus — Diseases of the stomach — Acute inflammation of the stomach, gastritis — Acute catarrh of the stomach, bilious attack — Cholera morbus — Cholera infantum — Chronic gastric catarrh — Dilatation of the stomach — Gastral- gia, or neuralgia of the stomach — Chronic ulcer of the stomach — Hemorrhage of the stomach — Cancer of the stomach — De¬ generation of the peptic glands — Diarrhea — Acute dysentery — Chronic dysentery — Colic — Enteralgia — Lead colic — Constipa¬ tion of the bowels — Intestinal hemorrhage — Intestinal obstruc¬ tions — Contraction — Twisting — Internal strangulation — Intus¬ susception — Hardened feces — Peritonitis — Abdominal dropsy, ascites — Consumption of the bowels, mesenteric consumption — — Dyspepsia — Errors in diet — General treatment — Removal of causes — Hygienic remedies — Diet — Table showing length of time required for digestion of various articles of food — Exercise — Rest and sleep — Traveling — Mental and Moral treatment — Dress — General measures of treatment — Baths — Inunction — Water¬ drinking — Special measures of treatment — To increase the secre¬ tion of gastric juice — Measures to increase muscular action — Flatulence — Acidity — Vomiting — Constipation — Acute dyspepsia — Simple dyspepsia, or slow digestion — Acid dyspepsia — Bilious or foul dyspepsia — Painful dyspepsia — Nervous dyspepsia — Mixed cases — An important caution — Depraved appetite — Polyphagia — Malacia and pica — Polydipsia — Inebriety — Intestinal parasites — Tape-worm — Round-worms, ascaris lumbricoides — Thread-worm, oxyuris vermicularis — Whip-worm, tricocephalus dispar — Strongy- lus duodenalis — Flukes — Diseases of the liver — Functional dis¬ eases of the liver — Torpid liver — Congestion of the liver — He¬ patitis, inflammation of the liver — Chronic inflammation of the liver — Inflammation of the bile-ducts — Gall-stones, biliary colic — Jaundice — Enlargement of the liver — Waxy liver — Fatty degen¬ eration of the liver — Hydatid tumor of the liver — Contraction XV111 CONTENTS. of the liver — Displacement and distortion of the liver — Enlarge¬ ment of the spleen, ague-cake — Symptoms relating to the digest¬ ive organs — Flatulence — Acidity — Heart-burn — Nausea — Vomit¬ ing — Regurgitation of food — Swallowing air — Heaviness at the stomach — Faintness — Pain in the stomach — Pain in the bowels — Pain in small of back — Pain beneath shoulder-blades — Fullness, weight and pain in right side — Pain under ribs on left side — Painful defecation — Tenesmus, or constant desire to relieve the bowels — Weakness in bowels — Loss of appetite — Voracious appetite . 872-972 Diseases of the Respiratory Organs — Physical diagnosis — Inspection — Palpitation — Mensuration — Succussion — • Percussion — Ausculta¬ tion — Breathing iu disease — Rales — The voice in disease — Expectoration — Consistence — Quantity — Odor — Color — Con¬ stituents of the sputum — Cold in the head, coryza — Chronic nasal catarrh — Ozena — Nosebleed — Epistaxis — Catarrh of the larynx' • — Croup — (Edema of the glottis — Spasm of the glottis, laryngis¬ mus stridulus — Throat consumption, laryngeal tuberculosis — — Paralysis of the glottis, loss of voice, aphonia — Acute bron¬ chitis — Capillary bronchitis — Chronic bronchitis — Winter cough — Bronchial croup or croupous bronchitis — Asthma — Spasm of the diaphragm — Hay-Asthma, or hay fever — Emphysema — Col¬ lapse of lung — Congestion of the lungs' — Hemorrhage of the lungs — Pulmonary apoplexy — Inflammation of the lungs, Pneumonia — Croupous pneumonia — Catarrhal or lobular pneu¬ monia — Chronic pneumonia — Consumption — Causes — 1. Im¬ pure air — 2. Improper diet — 3. Taking cold — 4. Tight lacing — 5. Contagium — 6. Sexual excesses — 7. Foreign bodies — 8. Va¬ rious diseases — 9. Alcoholic drinks — 10. Tobacco — 11. Depress¬ ing mental influences — 12. Heredity — 13. Prolonged nursing — 14. Climate — Treatment — 1. to check the fever. — 2. To im¬ prove the patient’s nutrition — 3. To arrest night sweats — 4. To alleviate the cough — 5. To develop the lungs — 6. To sustain and invigorate the patient in every possible way — Miliary tuberculosis —Pleurisy — Hydrothorax, dropsy of the chest — Pneumothorax — Symptoms relating to the respiratory organs — Cough — Chin cough — Stomach cough — Nervous cough — Painful cough — Hack¬ ing or tickling cough — Heavy or hollow cough — Dry or tight cough — Short, sharp cough — The hoarse, barking cough — The whooping cough — Pain in the chest — Shortness of breath — Sneezing — Hiccough — Foul breath . 973-1044 CONTENTS. xix Diseases of the Circulatory Organs. — The pulse in health — The pulse in disease — Frequent pulse — Febrile pulse — Feeble pulse — Thready pulse — Slow pulse — Quick pulse — Hard pulse — Inter¬ mittent pulse — Irregular pulse — Irritable pulse — Wiry pulse — - Palpitation of the heart — Hemorrhage as a symptom — Hypertro¬ phy, or overgrowth of the heart — Dilatation of the heart — Fatty degeneration of the heart — Pericarditis, inflammation of the heart- case — Endocarditis, inflammation of the lining membrane of the heart — Inflammation of the heart — Valvular disease of the heart — Embolism and thrombosis — Bupture of the heart — Palpitation of the heart — Angina pectoris — Basedow’s disease, or exophthal¬ mic Goitre — Aneurism of the heart — Disease of the arteries — Disease of the veins — Varicose veins — Inflammation of the Lym¬ phatics — Leuchsemia, white blood — Cyanosis, blue disease. ...1044—1000 Diseases of the Nervous System. — Causes of increased frequency of nervous diseases — Pain — Vertigo — Nervousness — Neurasthenia, or nervous exhaustion — Congestion or hyperemia of the brain — Anaemia of the brain — Apoplexy — Preventive treatment — Treat¬ ment during attack — Treatment immediately after the attack — Treatment of the after-results — Sunstroke — Brain fever — Soften¬ ing of the brain — Induration, or hardening of the brain — Hyper¬ trophy and atrophy of the^brain — Tumors of the brain — Spinal — ■ meningitis — Inflammation of the spinal cord, Myelitis — Paraly¬ sis of the lower limbs, paraphlegia — Spinal irritation, or spinal anaemia — Locomotor ataxia — Neuralgia — Hemicrania, Migraine — Face-ache, or facial neuralgia — Lumbago — Intercostal neuralgia — Sciatica — Crural neuralgia — Headache — Congestive headache — Anaemic headache — Sympathetic headache — Sick, or bilious headache — Nervous headache — Headache from other diseases — Chorea, or St. Vitus’ dance — Epilepsy, or falling sickness — Hys¬ teria — Catalepsy — Tetanus, lockjaw — Paralysis agitans, shaking palsy— Muscular atrophy, wasting palsy:-Neuritis, inflammation of the nerve — Facial paralysis — Temporary paralysis — Mimetic spasm of the face — Torticollis, wry neck — Writer’s cramp — Cramp — Sleeplessness, or insomnia — Somnambulism — Homesick¬ ness or nostalgia — Hypochondria — Insanity — Illusion — Halluci¬ nation — Delusion — Incoherence — Delirium — Mania— Melancholia Dementia — Paresis, or general paralysis of the insane — Idiocy and imbecility — Lead palsy, or wrist drop — Alcoholism — Delirium trrmens — The opium habit — The tobacco habit, — The tea and coffee habit — Fatty degeneration of the nerves — Disorders of Speech — Aphasia — Stammering — Stuttering— Seasickness. . .1000-4144 XX CONTENTS. Diseases of the TJrinary Organs. — Retention of the urine — Suppres¬ sion of the urine — Painful urination — Frequent urination — - Scanty urination — Color of the urine — Odor of urine — Taste of Urine — Reaction of urine — Density of Urine — Urinary deposits — Uric acid — Urates — Phosphates — Oxalate of lime — Pus in the urine — Bloody urine, or hematurea — Casts and ephithelium — • Chylous urine — Congestion of the kidneys — Hemorrhage from the kidneys — Acute inflammation of the kidneys, acute Bright’s disease — Chronic Bright’s disease — Abscess of the kidneys — Ab¬ scess near the kidneys — Fatty degeneration of kidneys — Waxy degeneration of the kidneys — Cancer and consumption of the kid¬ neys — Floating kidneys — Addison’s disease, bronze skin — Pye¬ litis, inflammation of the pelvis of the kidneys — Gravel in the kidneys, renal colic — Parasites of the kidneys — Catarrh of the bladder, cystitis — Hemorrhage of the bladder — Incontinence of the urine, enuresis— Spasm of the bladder — Paralysis of the blad¬ der — Irritability of the bladder — Gravel — Stone in the bladder — Tumors of the bladder . 1145-1168 Diseases of the Locomotive Organs. — Acute rheumatism — Chronic rheumatism — Deforming rheumatism, or rheumatic gout — Mus¬ cular rheumatism — Gout — Softening of the bone, mollitis ossium, ostomalachia — Fatty degeneration of the muscles . 1169-1178 Infections Diseases. — The germ theory of disease — Fever — The tem¬ perature — Classification of fevers — Febricula — Typhoid fever — - Typhus fever, ship fever — Relapsing fever — Bilious typhoid — Yellow fever — The plague — The black death — Sweating sickness, miliary fever — Erysipelatous fever, black tongue — Dengue, break- bone fever — Influenza, catarrhal fever — Mumps, or parotitis — Cholera — Whooping cough, chin cough, pertussis— Diphtheria — - Predisposing causes — Paralysis and other after-results — Local treatment — Disinfectants — Deodorants — General treatment — Pa- ralysis — Glander’s, farcy — Varicella, chicken-pox, wind-pox — Measles — German measles, rubeola — Scarlatina, scarlet fever — Rose rash — Cerebro -spinal meningitis, spotted fever — Small pox 1145-1240 Malarial Diseases. — What is malaria? — Chronic malarial poisoning — Protection from Malaria — Intermittent fever, ague-chills and fever — Treatment during the paroxysm — Ague-cake — Pernicious intermittent fever, congestive chills — Remittent, or bilious fever — Typo-Malarial fever — Masked intermittent . 1145-1254 CONTENTS. xxi Diseases of the Skin and Hair. — General principles of treatment — Various forms of eruption — Redness, or hyperacmia — Wheels — Papula, or pimples — Vesicles — Blebs — Pustules — Squamae, or scales — Tubercles — Nodules — Scabs, or crusts — Excoriations — Ulceration — Fissure — Cicatrix, or scar — Erythema — Urticaria, nettle-rash, hives — Heat-rash — Erysipelas, St. Anthony’s fire — Chilblains — Cold, or fever sores, herpes — Eczema, salt-rheum, moist tetter, scall — Psoriasis, dry tetter — Acne, face pimples — Comedo, or grubs — Pemphigus, water blebs — Impetigo — Ec¬ thyma — Pityriasis — Prurigo — Elephantiasis — Medicinal erup¬ tions — Oily skin — Dry skin — Dandruff — Milia and wens — Ex¬ cessive sweating — Offensive perspiration — Itching, pruritis — Purpura, the purples, land scurvy — Freckles, lentigo — Moth patches, liver spots, chloasma — Mother’s mark, mole, naevus — Albinism, piebald skin — Fishskin disease, ichthyosis — Slerodema — Keloid — Lupus, eating tetter — Callus — Itch, scabiei — Lice — Favus — Tinea versicolor — Hirsutes, overgrowth of the hair — Baldness — Gray hair, canities . 1255-1287 Diseases of the Male Generative Organs. — Inflammation of the pros¬ tate gland, prostatitis — Enlargement of the prostate — Balanitis — Catarrh of the urethra, urethritis — Priapism — Inflammation of the testicles — Nocturnal emissions, seminal losses, exhausted vital¬ ity — Treatment of self-abuse — Spermatorrhoea — Impotence — Ster¬ ility — Neuralgia of the testicles — Humors of the testicles — Syph¬ ilis, pox — Chancroid . 1287-1299 Diseases of Women. — Inflammation of the ovary — Congestion of the ovary, ovarian irritation — Ovarian dropsy — Inflammation of the uterus, Amenorrhaea — Scanty menstruation — Menorrhagia, pro¬ fuse menstruation — Metrorrhagia, uterine hemorrhage — Dysmen¬ orrhea, painful menstruation — Nymphomania — Sterility — Uterine catarrh, endometritis — Inflammation of the womb, metritis — Granular inflammation of the lips of the womb — Stricture of the uterine canal — Tumors of the womb — Displacement of the w7omb — Anteversion — Retroversion — Prolapsus of the womb — Flexions — Leucorrhaea, whites — Inflammation of the vagina, vaginitis — Vaginismus — Cystocele — Rectocele — Itching of the genitals, pru¬ ritis — Imperforate hymen — Inflammation of the breast, mastitis — Galactorrhaea — Overgrowth of the breast — Atrophy of the breast — Cracked nipple — Cancer of the breast — Fibrous tumor of the breast — Irritable breast — Rupture of the neck of the womb — Rupture of the perinaeum — Laceration of the perinaeum — Change of life — Coccyodynia, painful sitting — Enlarged abdomen. . . .1300-1338 XXII CONTENTS. Obstetrics or Midwifery.— Signs of pregnancy — Quickening — Hygiene of pregnancy — Parturition without pain — Exercise — Diet — Dress — Bathing — Care of the breasts — Mental conditions — Labor of childbirth — Presentation and position — Stages of Labor — Man¬ agement of labor — Washing and dressing the child — The binder — Milk fever — Care of the breasts — Sore nipples — Inflammation of the breast — To check the secretion of milk — To promote the secretion of milk — Getting up — Hemorrhage after labor — Deten¬ tion of the after-birth — Inactivity of the womb — Frigidity of the womb — Rigidity of the perinseum — After-pains — The use of ergot — The use of anaesthetics — Twins — Abdominal pregnancy.. .1339-1358 Disorders of Pregnancy. — Constipation — Piles, or hemorrhoids — Morning sickness — Disorders of the bladder and womb — Itching genitals — Vaginal discharges — Varicose or enlarged veins — Drop¬ sical swelling of the feet and limbs — Difficult respiration — Head¬ ache and disturbance of sight — Neuralgia — Miscarriage and abor¬ tion — Premature labor — Death of the fetus — Molar or false preg¬ nancy — Flooding — Puerperal convulsions — Puerperal fever. . 1359-1365 Feeding and Care of Infants. — Infant diet — Cautions respecting infant i'eeding — Weaning — General care of infants — The bowels and bladder — Clothing — Bathing — Sleeping — Exercise — Teething 1366-1373 Diseases of Children. — General appearance — Pulse — Respiration — Ex¬ pression of countenance — Gestures — The cry — Posture — The eye — The tongue — Development — The bowels — General Symptoms — Convulsions — Infantile trismus, nine day fits — Tetanie — Night terrors, nightmare — Acute hydrocephalus, tubercular meningitis — Chronic hydrocephalus, water on the brain — False dropsy of the brain — Paralysis of the soft palate — Infantile paralysis— Spina- bifida, cleft spine — Rickets, rachitis — Consumptive constitution — Cephalhematoma, blood tumor of the scalp — Pain in the bow¬ els — Vomiting — Infantile dyspepsia — Worms — Skin eruptions 1371-1393 ACCIDENTS AND EMERGENCIES, Sudden illness — F ainting — Convulsions— Apoplexy— Sunstroke — V ertigo — Sudden mania — Shock — Hemorrhage — Bleeding from the nose — Hemorrhage from a cut throat — Hemorrhage from the arm or leg — Hemorrhage from the palm of the hand — Bice 1- ing from the gums — Hemorrhage from the arm below the elbow, CONTENTS. xxm or the leg below the knee — Hemorrhage from the stomach — Hem¬ orrhage from the lungs — Hemorrhage from the bowels — Bleeding from a rupture of varicose veins — Wounds — Punctured wounds — Torn and contused wounds — Dissection wounds — Bites of animals Hydrophobia, rabies — Snake bites — Bites and stings of insects — Bruises — Strains — Sprains — Burns and scalds — Fractures — The healing of fractures — General treatment of fractures — Bandages — Splints — Pyaemia and septaemia — Fractures of the skull — Frac¬ tures of the spine — Fracture of the nose — Fracture of the lower jaw — Fracture of the upper jaw — Fracture of collar bone — Frac¬ ture of the ribs — Fractures of the humerus — Fractures of the forearm — Fracture of the bones of the hand — Fracture of the fingers — Fracture of the thigh — Fracture of the knee-pan — Fracture of the leg — Fractures of the bones of the foot — Dislo¬ cations — Treatment of dislocations — Dislocation of the jaw — Dis¬ location of the shoulder — Dislocation of the elbow — Dislocation of the wrist — Dislocation from pulling the arm — Dislocation of the thumb and fingers — Dislocation of the hip — Dislocation of the knee-joint — Dislocation of the ankle — Dislocation of the bones of the foot — Dislocation of the toes — Miscellaneous accidents — Treatment of the drowned — Lightning-stroke — Freezing — Clothes on fire — Swallowing foreign bodies — Choking — Dirt in the eye — - Lime in the eye — Foreign bodies in the ear — Foreign bodies in tlie nose — Accidental poisoning — Specific methods of treatment in cases of poisoning — Table of poisons and their antidotes . 1394-1445 ■ SURGERY. Abscess — Boils — Carbuncles — Bed-sores — Ulcers — Synovitis — Gangrene — Senile gangrene — V aricose veins — Aneurism — Vas¬ cular growths — Enlargement of the lymphatics . 1446-1455 Diseases of the Hands and Feet. — Ag-nail — Hang-nail — Run-around — Claw-like nails — Felon — Warts — Corns — Bunions — Stone bruises — Cracks between the toes — Ingrowing toe-nails — Deformities of hands and feet — Clubbed hands — Club-foot — Flat-foot— Deform¬ ities of the feet from improperly made shoes — Weak ankles — Bow-legs, or bandy legs — Knock-knee, or genu valgum — Short leg . . . T . . 1466-1468 Diseases of the Eye. — Congestion of the conjunctiva, or mucous membrane of the eye — Catarrhal conjunctivitis, cold in the eye — Purulent conjunctivitis, suppurative inflammation of the eye — Inflammation of the eyes in the newly born — Sympathetic in- XXIV CONTENTS. flammation of the eye— Granular lids, trachoma — Inflammation of the edges of the lids — Acne of the eyelids — Blear eyes — Stye, hordeolum — Pterygium — Tumors of the eyelids — Ptosis, inabil¬ ity to open the eye — Inability to close the eye — Deformities of the eyelids — Wild hairs in the eye — Spasm of the eyelids — Twitch¬ ing of the eyelids — Adhesion of the lids — Epiphora, weeping eye — Cross-eye — Oscillation of the eyes — Inflammation of the cornea — Ulcers of the cornea — Opacities of the cornea — Arcus senilis — Iritis — Dilated pupils, mydriasis — Contraction of the pupil — Myosis — Cataract — Disease of the choroid or color coat of the eye — Disease of the retina — Disease of the optic nerve — Glan- coma — Specks before the eyes — Muscae volitantes — Amaurosis Pain in the eye — Blurred sight — Loss of sight — Test types — Old- . sight — Long-sight — Short-sight — Astigmatism — Glasses — Color blindness . 1479-1506 Diseases of the Ear. — Discharge from the ear — Abscesses in the audi¬ tory canal — Earache — Hardened ear-wax — Ringing in the ears, tinnitus aurium — Parasitic inflammation of the auditory canal — Acute catarrh of the ear — Chronic catarrh of the middle ear — • Nervous deafness — Rupture, or perforation of the membrane of the ear— rEar trumpets — Deaf-mutism . 1506-1517 Tumors. — Fibrous tumors — Fatty tumors — Cartilaginous tumors — Bony tumors — Cystic tumors — Horny tumors — Cancer . 1518-1520 Miscellaneous Surgical Diseases and Operations. — Ligation of blood¬ vessels — Hare-lip — Cleft palate — Restoration of nose — Polypus in the nose — Elongated uvula — Gum boil — Tartar on the teeth — Decay of teeth— Tongue-tie — Removal of tongue — Ranula — Tra¬ cheotomy — Goitre — Hernia — Piles — Fissure of the anus — Itch- in sr of the anus — Abscess near the anus — Fistula in ano — Ulcer O of the rectum — Stricture of the rectum — Prolapsus of the rectum — Polypus of the rectum — Absence of anus — Artificial anus — Use of the catheter — Urinary calculus — Extroversion of the blad¬ der — Hypospadias — Stricture of the urethra — Varicocele— Hy- » drocele — Phimosis — Paraphimosis — Circumcision — Castration 1520-1530 LIST OF ILLUSTRATIONS Fm. Page. 1-8. Illustrate protoplasm and cells . 3d 9, 10. White and yellow fibrous tissue . 40 11, 12. Connective and adipose tissue . 41 13. Cartilage tissue, showing the character¬ istic cells . 42 14. Transverse section of bone as seen with the microscope . 43 15. Magnified view of longitudinal section of bone . 43 16. Muscular tissue showing smallest fibres with striae . 44 17. Non-striated muscular fibres . 41 18. Nerve cells, showing poles . 45 19. Nerve fibres, showing fibrillae . 45 20. Epithelial cells . 47 21. 22. Skeleton, and long bone, showing periosteum . 50 23. Longitudinal section of the large end of a Done . 51 21. Skull, showing the sutures . 52 25. “ with bones separated . 62 26. “ “ outer plate removed, showing the diploe and the channels for blood¬ vessels . 53 27. The spinal column . 56 28. Vertical section of two contiguous verte¬ brae, showing their spongy structure and cartilage between them . 56 29. The first vertebra, called the atlas . 57 30. Bones of the foot . 62 31. Malleus, incus, and stapes . 63 32. Designed to show how the jar of walking is prevented from reaching the brain. . 64 33. Bone rendered flexible and tied in a knot 66 34. Section of vertebrae, showing fibro-carti- lage disc of normal shape . 71 35. Showing cartilage thickened as the re¬ sult of anterior curvature . 71 36. Showing cartilage thinned, as result of posterior curvature . . 71 37. Double curvature of the spine . 72 37. Fusiform muscle . 77 38. Pennate “ . , 77 39. Fan-shaped “ 77 40. Circular “ 77 41 General view of the muscles . 78 42. Muscles of the head and neck . 79 43. “ “ face “ “ 80 44. Showing muscles of the eye . 80 45. “ “ “ trunk . 81 46. Illustrating first kind of lever . 86 47. “ second “ “ 86 48. “ third “ “ 86 49. Second kind of lever ill. by the foot . 87 50. Third “ “ “ “ arm . 87 51. Di-gastric, illustrating the pulley . 88 52. Waist of natural shape . 100 53. “ compressed by tight-lacing . 100 54. Ribs in their natural position . 101 55 “ distorted by corset-wearing . 101 56. Chinese lady's foot and slipper . 103 57, 58. Improper positions in sleeping . 107 59, 60, 61, 62. Improper positions in sitting. 108 61. Proper position “ “ 109 64. Unhealthy position made necessary by old-style school seat . 110 Fig. . Page 65. Correct attitude encouraged by Auto¬ matic school seat . Ill 66. Improper position in standing . 112 67. Proper “ “ “ . 112 68. General view of nervous system . 116 69. The brain and spinal cord . 117 70. View of upper surface of brain . 117 71. “ “ under “ “ showing the origins of several pairs of nerves. 118 72. The left half of the brain . 118 73. Horizontal section of the brain through its middle portion, showing relation of the white matter to the gray . 119 74. View of the cranial nerves, with their points of origin in the brain . 119 75. View of Sympathetic Nervous System. . . 121 76. Diagram showing position of “bumps” as located by phrenology . 153 77. Illustrating sense of touch . 168 78. The ear, showing all three parts . 175 79. Incus, malleus, and stapes . 176 80. The internal ear . 177 81. The eye, showing apparatus for remov¬ ing tears from the eye . 182 82. Glandular apparatus of the eye . 183 83. Vertical section of the eyeball . 184 84. Diagram, showing optical properties of lenses . 187 85. Card, showing limit of accommodation to the eye . 189 86. Crystalline lens, adjusted for different distances . 189 87. Illustrates the blind spot on the retina.. 192 88. The heart . 202 89. Shows two sides of the heart and their cavities . 203 90. Double heart of dugong . 203 91. The heart with portions of its walls re¬ moved, showing interior cavities . 204 92. Heart, showing relative size of its cavi¬ ties and thickness of the walls of ven¬ tricles . 204 93. The arterial system . 205 94. “ venous “ 206 95. Valves of veins closed . 207 96. “ “ as they appear when the vein is slit open . 207 97. Diagram, showing valve between auricle and ventricle open, and semi-lunar valve closed . 207 98. Diagram, showing valve between auricle and ventricle closed, and semi-lunar valve open . 208 99. Tracing of the pulse obtained by the sphygmograpli . 209 100. Diagram of the circulation . 210 101. Diagram showing direction of blood current in blood-vessels . 211 102. Shows how valves of the veins aid the circulation . 213 103. Red and white blood corpuscles . 216 104. Red blood corpuscles . 217 105. Lymphatic gland . 221 106. Lymphatic glands and vessels of the head and neck . 222 107. Lymphatic vessels of arm . 223 (xxv) XXVI LIST OF ILLUSTRATIONS. Fig. Page. 108. Lymphatic vessels showing valves . 223 109. Means of protecting back of head and neck from exposure to the sun . 230 110. The pharynx . 231 111. The larynx . 231 112. The air-passages of the lungs . 232 113. Lobules of lung, showing air-cells . 233 114. Cut showing relation of lungs and heart 234 115. “ “ how capacity of chest is enlarged by expansion of its walls, &c. 235 116. A literal view, illustrating the same. . . 235 117. Relative capacity of the chest and po¬ sition of diaphragm after complete ex¬ piration . 237 118. Relative capacity of the chest and posi¬ tion of the diaphragm after a full in¬ spiration . 237 119. Spirometer . 241 120. The alimentary canal . 246 121. The mouth . 247 122. The temporary or milk teeth . 248 123. The permanent teeth . 249 124. The stomach and portion of duodenum. 250 125. Villi of intestines magnified . 252 126. Villi of intestinal mucous membrane. .. 252 127. Folds of intestinal mucous membrane. 253 128. Pancreas, duodenum, spleen . 253 129. Portion of intestinal canal, showing mesenteric glands and lacteals . 264 130. Root of a hair . 302 131. The kidney . 313 132. Internal structure of kidney . 313 133. Spleen . 314 134. Sexual organs of plants . 321 135. Spermatozoa; human, and of lower ani¬ mals . 321 136. Human ovum . 322 137. Diagram illustrating segmentation of ovum . 325 138. Ovum after fecundation . 325 139. Chang and Eng, Siamese twins . 339 1*0. Starch Granules . 363 141. Milk globules . 365 142. Fat cells . 365 143. Grain of wheat magnified . 367 144. “ “ “ with husk removed _ 367 145. Transverse section of grain of wheat . . 367 146. Cut showing various layers of the grain of wheat . 367 147. Same as Fig. 146 more highly magni¬ fied . 368 148. Same as Fig. 146 greatly magnified . 368 149. Teeth of carnivorous animal . 880 150. Skull of baboon tfrugivorous) . 330 151. “ “ wild boar (omnivorous) . 3so 152. “ “ rodent . 330 153. Skull of chimpanzee . 381 154. The human skull . 381 155. Measly pork containing young tape¬ worms . 395 156. Trichinae.— Two in a single capsule . 397 157. Meat containing trichinae in calcareous cysts . 398 158. Same as Fig. 157 enlarged . 393 159. Healthy milk as seen through the micro¬ scope . 403 160. Diseased milk . 403 161. Spurred rye, or ergot . 40 162. Ergot grains enlarged . 407 163. Flour infested with rust as seen under the microscope . 408 164. The rust fungus . 409 165. Spores of smut bolls . 409 166. Spores of yeast . .. 412 167. Yeast fungus . 413 168. Green mold of old cheese and stale 414 bread . . 169. A reservoir filter . 446 Fig. Page. 170. Same as Fig. 169, but showing filter in sections . 446 171. Simple form of filter . 447 172. Another filter . 447 173. Pocket filter . 447 174. Cistern filter . 448 175. Nicotiana Tabacum . 506 176. Stem of tea plant, showing flowers . 519 177. Leaf and fruit of ci coa . 520 178. Mate or Paraguay tea . 621 179. Candle extinguished by carbonic acid.. gas . 542 180. Pouring carbonic acid gas . 542 181. Atmospheric germs greatly magnified.. 548 182. Pail for use with dry-earth system . 555 183. Dry-earth pail in position . 555 184. Trap for drain . 558 185. 186, 187. Experiments with carbon gas. 565 188, 189. Evils of window ventilation . 563 190. Best ventilation . 569 191. Stove-pipe ventilator . 570 192. Air inlet box . 571 193. Ventilation working wrong way . 572 194. Diagram showing defective system of ventilation . 572 195. Stove-pipe ventilation . 575 196. Wet rubbing sheet . 640 197. Wet-sheet pack . 642 198. Shower pack . 644 199. The full bath . 645 200. Portable rubber bath . 646 201. The half bath . 647 202. The shower bath . 649 203. A simple shower bath . 650 204. Vapor bath . 651 205. The sitz-bath tub . 653 206. Leg bath . 654 207. Foot bath . 655 208. The drop bath . 658 209. Arm bath . 658 210. The nasal douche . 660 211. The syphon syringe . 661 212. The syphon syringe so arranged as to supply a large quantity of water . 662 213. Application of continuous cold to the.. chest for hemorrhage of lungs . 679 214. Double bag for applying continuous cold to the knee . 680 215. Ice head-cap . 680 216. Spinal ice-bag . 680 217. Pneumatic cabinet . . 682 218. Apparatus for inhaling compressed air. 682 219. Juuod’s boot with air pump . 683 220. Junod's arm . 6 S3 221. Faradic battery . 688 222. Family faradic battery . 639 223. Galvanic battery . 692 224. Galvano-cautery battery . 692 225-203. Instruments used in applying elec¬ tricity . 693 231. Administering electricity . 6 '4 2 )2-266. Swedish Movements . 708-717 267-272. Muscle-beating . 717-720 273. A steam inhaler . 802 274. Section of an inhaler . 802 275. Improved stomach pump . . 898 276. Egg of tienia saginata . 947 277. Egg of taenia bothriocephalus latus _ 947 278. Egg of tienia solium . 947 279. 280. Embryo of tape-worm . . 947 281. Sections of tsenia solium . . . 943 282. Sections of tienia saginata . 1 . 948 283. Head of tape-worm . 949 284. Round worm, natural size . 950 285. Thread worm, natural size . 951 286. Thread worm shedding its skin . 952 287. Whip worm . . 952 288. Natural size and position of liver _ 961 LIST OF ILLUSTRATIONS. xxvii Fi®. Page. 289. Greatly enlarged liver . 962 290. Gin-liver . 963 291. Liver distorted by tight lne'ng . 964 292. Liver deformed by compression . 965 293. Liver Bhowing effects of compression.,. 965 294 . 966 295. “Tight-lace fissure” of the liver . 966 296. Using the laryngoscope . 973 297. Healthy vocal cords. . * . 974 298. Ulceration of vocal cords . 974 299. Tongue depressor . , . 974 300. The stethoscope . 976 301. Relative position of internal organs _ 978 302. Parement epithelium from the mouth., . 980 303. Cylindrical epithelium . 980 304. Yellow elastic tissue fibre from lungs. 981 305. Cast of bronchial tubes, . 981 306. Plugging the nose . 988 307. Magnified portion of lung affected by emphysema . 1006 308. Residual air-pump . 1007 309. Respirator . 1008 310. Applying cold to chest for hemorrhage of lungs . 1012 311. Magnified portion of lung tissue in con¬ sumption . 1023 312. Pneumatometer . 1030 313. Spirometer . 1030 314. Aspirator . 1038 315. Pulse of a healthy person . 1045 316. Irregular pulse of a tobacco-user . 1045 317. Transfusion of blood . 1057 318. Hypodermic syringe . 1066 319. 320. Showing points at which electricity should be applied to affect special nerves and muscles . 1085 321. Splint for wry neck . 1113 322. Apparatus for relief of writer’s cramp 1114 323. Strait-jacket . 1133 324. 325. Crystals of uric acid . 1150 326. Crystals of triple phosphates . 1151 327. “ “ oxalate of Jime . 1151 328. Pus cells . 1152 329. Epithelial casts . 1152 330. Granular ** 1152 331. Hyaline “ . 1 52 332. Congested kidneys . . . 1153 333. Hand deformed by rheumatism . 1175 334. Healthy muscular fibres . 1178 335. Fatty muscular fibres . 1178 336. Fever thermometer . 1180 337. A diphtheritic throat . 1209 338. Diphtheritic germs . 1211 339. Female itch mite laying eggs in a bur¬ row . 1277 340. The head louse . 1279 341. The body or clothes louse . 1279 342. The crab or pubic louse .". . 1279 343. Nits or eggs of head louse . 1279 344. Ringworm parasite, greatly magnified. . 1281 345. A hair affected by ringworm, . 1281 346. Fungus of favus . 1282 347. Parasitic fungus of tinae versicolor . 1283 348. 349. Examples of hirsutes . 1283 350, 351. Rubber nipples for nursing-bottles 1367 352-354. Side, vertex, and front view of head of hydrocephalic child . 1383 355. Compression of artery of the arm . 1397 356. Another method . 1398 357. Centipede . 1407 358. Scorpion . 1407 359. Jigger . 1407 36 ». Bedbug . 1407 361. Tick . 1407 362. Flea highly magnified . 4407 363. Lancet of musquito . 1408 364. Tarantula . 1408 365. 366. The roller bandage and the mode of applying it . 1415 1 AiiiVt 367. A limb after being bandaged . 1415 368. Bandage for factored jaw, . 1417 369, 370. Adhesive straps for fractured collar- 371. Adhesive plaster for fractured ribs . 1419 •U2- Splint for fracture of the arm-bone .... 1419 373. Apparatus for fractured thigh, . 1422 374. Illustrates method for treating frac¬ ture of the knee-pan . 1423 375. Fracture box . 1424 376. Illustrates method for reducing dislo¬ cated shoulder by pulley . 1427 377. Apparatus for dislocated shoulder . 1428 378. Dislocated thumb . 1429 379. Apparatus for setting dislocated finger. 1429 380. Illustrates method of reduction by pul¬ leys for dislocated hip . 1430 331-385. Restoration of the drowned _ 1432-1435 386. Clothing on fire, . 1437 387. Bristle probang . 1438 388. Scalpel . 1447 389. Bistoury . 1447 390. Air cushion . 1449 391. Amputation of the arm . 1454 392. Apparatus for stiff joint . 1457 393. Another appparatus for the same . 1458 394. 395. Ilip-joint disease . 1459 396. Hip splint . 1460 397. Harness for spinal curvature . 1461 398. Wheel carriage . 1.462 399. Apparatus for curved spine . 1462 400. Lateral curvature of spine . 1463 401. Spinal swing . 1463 402. Apparatus for lateral curvature . 1464 403. House-maid’s knee . 1465 404. Section of acorn . 1469 405. Distorted foot . 1470 406. Apparatus for bunions . 1470 407. Apparatus for ingrowing nail . 1471 408-418. Congenital deformities of the hands and feet . 1472 419. Talipes eqninus . 1473 420. Talipes valgus . 1473 4.1. Talipes varus . 1473 422. 1’alipes Calcaneus . 1473 423. Talipes Calcaneus . 1473 424. Shoe for talipes calcaneus . 1474 425. Shoe for talipes varus . 1474 426. Outline sole of a normal foot . 1474 427. Outline sole of normal foot showing size of fashionable shoe . . 1474 428. Effects of wearing narrow-toed shoes.. 1474 429-431. Deformed feet from improperly made shoes . 1475 432. Deformi y of Chinese woman’s foot .... 1475 433. Outline of sole of Chinese woman’s foot 1475 434-436. Ou line of improperly made shoes.. 1476 437, 438. Outline of soles of the Meyer’s shoe 1476 439. Shoe and brace for weak ankles . 1477 449. Brace for bandy leg . 1477 441. Brace for knock-knee . 1478 442. Extension for short leg . 1478 443. Apparatus for short leg . 1478 444. Dirt in the eye . 1484 445. Bowman’s probes . 1491 446. Medicine dropper . 1494 447. Cataract knife . 1495 448,449. Ophthalmoscope . 1496 450. Convex lens . 1500 451. Eyeball of long-sighted eye . 1503 452. Shor -sighted eye . 1503 453. Bi concave lens . 1504 454. Test diagram . 1505 455. Politzer’s rubber bag . 1511 456. Eustachian catheter . 1512 457. Diagnostic tube . 1512 458. Ea specula of three sizes . 1514 459. Bi-valve ear specula . 1514 460. 461. Ear trumpets, . 1515 XXV111 LIST OF ILLUSTRATIONS. Fig. Page. 462. Auricles . 1515 463. Conversation tube . . 1515 464. Silver cornets . 1515 465. Artificial drum membrane . 1515 466. Audiphone . 1515 467* 494. Deaf and dumb alphabet . 1517 Fig. Page. 495. Artery forceps . 1520 496-498. Hare-lip . 1521 499. Truss . 1524 500. Probe-pointed bistoury . 1526 501. Catheter . 1528 502. Lilhotrite . 1529 LIST OF COLORED PLATES. Plate I .—THE SKELETON. Plate II.— THE MUSCLES. Plate III.— THE NERVOUS SYSTEM. Plate IN.— THE SKIN. Plate N.—THE CIRCULATION. Plate VI.— THE HEART , BLOOD CORPUSCLES , AND CIRCULA¬ TION IN THE FOOT OF A FROG. ' Plate VII.— DIAGRAM OF INTERNAL ORGANS. Plate VIII.— DEMODE X FOLLICU LO RUM AND ACARUS SCABIE1. Plate IX. TRICHINAE AND OTHER PARASITES. Plate X. — PA RA SITES FOUND IN MEAL AND SUGAR. Plates XI, XII.— LEAVES OF TEA , AND VARIOUS LEAVES USED IN ADULTER A TION. Plate XIII.— ANIMALCULES AND INFUSORIA IN WATER. Plate XIV.— EFFECTS OF ALCOHOL AND TOBACCO. Plates XV, XVI .—ILLUSTRATING INSANITARY CONDITIONS. Plate XVII.— POISON IVY— STRAMONIUM. Plate XVIII.— BLACK HELLEBORE— FOXGLOVE. Plate XIX.— FOOL'S PARSLEY— FLOWERS AND ROOT OF ACONITE. Plate XX.— GARDEN NIGHTSHADE— INDIAN TURNIP. Plate XXI .—HENBANE— SHEEP LAUREL. Plate XXII.— YELLOW JASMINE— MAY APPLE. ANATOMY, PHYSIOLOGY, and HYGIENE. Definitions. — Anatomy is derived from two Greek words which literally signify to cut, or dissect. The word is used to designate the study of the form, structure, and other apparent properties of organ¬ ized bodies, whether animal or vegetable. In our use of the word it will be confined to the study of the human form. Comparative anat¬ omy is the study of each separate organ of an animal as compared with corresponding organs in other animals ; this is one of the most fascinating and instructive branches of science. Our space will not allow of the extended study of this division of anatomy, but we shall call attention to some of the more interesting and important points connected with the subject. Physiology is a term derived from two Greek words which liter¬ ally mean a description of nature. When first coined by the ancient Greeks the word meant essentially the same as does the term physics at the present day. The philosophers of ancient Greece led their pu¬ pils about among the fields, through forests, and beside the lakes and rivers of that picturesque country, discoursing of the various animals, plants, rocks, and other natural objects which attracted their attention. This was a literal study of nature, and the study was called physi¬ ology. The term is now used to denote the science of the functions of living creatures. We have vegetable physiology as well as animal and human physiology. There is also comparative physiology, the complement of comparative anatomy, already defined, which relates to the comparative study of the functions of various animals. Hygiene is a word taken directly from the French language. It is used to signify the study of those laws which relate to the healthy action of the various organs of the body. It is one of the most im¬ portant and practical of all the subjects with which we have to deal, and will receive a proportionate amount of attention, both in connec¬ tion with the study of the anatomy and physiology of the several or¬ gans of the body, and in chapters especially devoted to the subject. (25) 26 ANATOMY, PHYSIOLOGY, AND HYGIENE. Man’s Place in Nature. — Much has been said of late regarding man’s place in nature, the general drift of the discussion of the sub¬ ject being to show that man is but the final product of a process of development which in the course of some millions of ages has raised him from a mere speck of dust to his present position at the head of all animate objects which come within the scope of our knowledge. It is not in this sense that we wish to speak of man’s position in the universe. We wish to direct the reader’s attention to the following facts : — 1. That man is a part of the material universe. Whatever theory may be held respecting his nature, whether it is partly material and partly spiritual, being double, or whether wholly spiritual as affirmed by some or wholly material as claimed by others, it is generally con¬ ceded that science recognizes man only as a material object, a part of the great universe of matter, wonderfully complex in his constitution and organized with the most marvelous delicacy, yet no less a part of the world of matter which appears on every hand in such wondrous diversity of forms. 2. That man is subject to the same general laws which govern other material objects. The same destructive agents which effect nearly all the changes in matter, fire, water, gases, and various chem¬ ical agents, operate upon man as upon other material objects. The law of gravitation holds him to the earth in precisely the same man¬ ner as though he were a stone. Electricity, that most potent of all the subtle, unseen agencies of nature, operates upon man as upon other objects, animate or inanimate, using him as a conductor when no more easy passage is at hand, utterly disregarding his presence cr existence when a more facile route is offered. So with all the a^en- O cies and forces of nature. 3. That the special laws which govern all organized bodies relate to man in common with all other animals and vegetables. It will be clearly seen by our future study of the human constitution that man is but a part of tl e general scheme of organization which includes all animal and vegetable life. Man is not a vegetable, but possesses many things in common with the lowest forms of vegetable life, even the microscopic mold which vegetates upon a stale fragment of bread. The Constitution of Matter. — In order for us to fully under¬ stand the varied relations of the human form divine to the rest of the universe, we must first study physiology in its broad, original MATTER THE BASIS OF EXISTENCE. 27 meaning ; that is, we must study nature as a whole sufficiently to gain a knowledge of the great general laws which lie at the founda¬ tion of all existence animate or inanimate. By this study we shall discover that a senseless, lifeless stone may rightfully claim kinship with a king upon his throne. We shall learn that there is a common brotherhood existing between all material things. Nor will this knowledge, as some might fear, in any degree detract from the dig¬ nity of man, the lord of creation, though it will add to the dignity of many objects which we are, through the influence of early erro¬ neous education, inclined to look down upon. Before entering upon a more precise account of the nature and constitution of matter, we must premise a few points with which we are sure all candid, thinking persons will agree. 1. We possess very little positive knowledge on any subject. Whenever we attempt to get back to fundamental propositions, we find that nearly all our reasoning is based upon assumptions. 2. Nevertheless we must have something as a starting-point in all lines of thought or reasoning ; and in the absence of absolute or positive knowledge, the only proper course left for us to pursue is to assume that which is the most 'probable . 3. That which all will agree in accepting as the most probable is that which presents the most evidence in its favor, even though none of the evidence may be absolutely conclusive. 4. The various organs of sense are our only means of receiving knowledge ; hence we must accept the evidence of the senses, weighed by reason, as to what is most probable. Matter tlie Basis of Existence. — Viewing the subject in the light of the propositions stated, we are shut up to the conclusion that matter is the basis of all existence. We do not affirm that there is no other than material existence. We know that there must be, since ideas, qualities, and all abstract things exist, though immaterial ; but still, science recognizes matter as the basis of all, since abstract exist¬ ence is only possible through the relation of abstract to concrete things. To illustrate, sweetness cannot exist independent of some sweet thing, and depends for its existence upon that object. So with all other properties, qualities, and relations. Science does not deny the existence of other than material entities, but does declare its ina¬ bility to recognize them, since it can deal only with material things, which must be evident to all when it is recollected that man possesses 28 ANATOMY, PHYSIOLOGY, AND HYGIENE. only seven senses, none of which are capable of recognizing any other than material objects. Any knowledge of immaterial objects must be obtained elsewhere than through scientific investigation. In this, all scientists are agreed. The Nature of Matter. — All the evidence we have on this subject points to the conclusion that all material things are composed of infi¬ nitely small particles which are indivisible, and which possess certain properties common to all forms of matter. For instance, we will sup¬ pose that we take a rock and grind it into an impalpable powder. Now we will take as small a quantity of this dust as will adhere to the point of a pin. Placing it upon a perfectly clean slip of glass, we will look at it with a powerful microscope. The invisible particles now appear each like a great rock rivaling in proportions the original mass. Now, by means of delicate appliances, we will divide one of these portions into particles so fine as to be invisible even with the microscope employed. A much more powerful instrument still brings them into view. Another subdivision by chemical means places the particles beyond the power of any microscope, yet the spectroscope will still discover their presence, so that we know they are not lost. So far as our knowledge goes, no further subdivision can be made, and the ultimate, invisible particles are known as atoms. Atoms do not exist separately, but are combined in groups, which are known as molecules. The size of atoms cannot be accurately known ; but it has been determined within certain limits by calculations based on very proba¬ ble data, the results of which seem to show that if an apple were mag¬ nified to the size of the earth, the atoms which compose it would be not larger than cricket balls nor smaller than fine shot. Force and Atoms. — A mischievous doctrine has been taught from early ages down to the present time respecting the nature of force and its relations to matter and material objects. The ancient and popu¬ lar view has been that force is a separately existing something which operates upon matter and material objects, producing all the various changes and operations observable in matter. Science has in modern times thoroughly exposed the fallacy of this theory. What evidence we have on this subject goes to establish the view that force is but a property of matter, and that it is inseparably connected with matter. That matter and force are inseparable is quite patent when we at¬ tempt to conceive of either one as existing alone. Such a conception ORGANIZATION — LOWEST FORMS OF LIFE. 29 is as impossible as the formation of an idea concerning a thing which is utterly devoid of properties. It is further established by philosophical research that each atom possesses a certain definite amount of force, which is of necessity un¬ changing. This force may be sometimes active in one way, and some¬ times in another, but is always present. We do not need to trouble ourselves with the various theories respecting the exact nature of atoms, since the general principles laid down hold equally good with all. Whether atoms are hard, indivisi¬ ble particles, or whether they are something different, does not mat¬ ter, since we do know that they possess certain definite properties, many of which have been determined. It may be, indeed, that, as not a few eminent philosophers have supposed, there is but one funda¬ mental atom and one primary force ; still, our reasoning holds good. Organization. — As matter is the basis of material existence, so or¬ ganization is the basis of life in its great diversity of forms. This question has been the subject of an almost endless amount of discus¬ sion, which we shall not attempt to review here. We will simply state as before, and we do so without fear of successful contradiction, that what evidence we have on the subject leads directly and irresist¬ ibly to the conclusion that life is the result of organization, being the manifestation of the forces of nature connected with matter, modified by a peculiar arrangement. This special arrangement, which occa¬ sions the peculiar manifestations constituting the phenomena of life, is what is known as organization. All that makes a plant different from the soil out of which it grows, and the air and water which nourish it, is the peculiar arrangement given to the various elements which are taken in from the surroundings of the plant. The organi¬ zation of a plant is analogous to the organization of an army or a gov¬ ernment, simply an arrangement of the component parts. Each par¬ ticular plant has its own peculiar arrangement, just as each particular government has its peculiar organization. Destroy the organization, and the life which depended on it is also destroyed. What is true of a plant is also true of an animal, and of a human being. Lowest Forms of Life. — A little speck of scum from a stagnant pool or a drop of slime from a moist rock by the sea-shore, when viewed with a good microscope, is seen to be almost wholly made up of minute living organisms. Stagnant water always teems with these low forms of life. In some localities the bottom of the sea is covered 30 ANATOMY, PHYSIOLOGY, AND HYGIENE. with them. Some of the simplest forms of these minute organisms are mere specks of life which do not differ much in appearance from particles of dust. Indeed, eminent observers have not infrequently confounded these curious little living atoms with inanimate dust. A close inspection, however, shows that they possess some very different properties from dust particles ; in other words, that they are alive. Other forms appear like little drops of jelly. Round, transparent, they might be easily mistaken for bubbles or masses of some gelati¬ nous substance were it not that now and then they will be seen to move. If watched closely, it will be observed that they change their form and position, and even eat. They possess no eyes, no mouth, no teeth, no organs of locomotion, in fact are nothing apparently, but tiny jelly drops ; and yet they seem to be conscious, they move about from place to place, and feed upon the little particles with which they come in contact. Here is life in its most lowly form. It is not hard to think that these tiny creatures, so like the inanimate particles with which we are familiar in the study of chemistry and physics, are but unique ar¬ rangements of the same matter which in other forms obeys the well- known laws of matter in its simplest forms. The Basis of Life. — The little jelly drop sustains to higher or¬ ganisms the same relation that the atom does to all ether forms of matter. It is the basis of life. Protoplasm is the technical term which scientists apply to the atom of living forms. Out of these sim¬ ple forms of life all higher and more complex organisms are formed. This is true of animals as well as vegetables. Take a man in pieces, and he will be found to be made of similar masses connected together by various devices. Dissect a tree, and the same will be found to hold true. Examine a drop of blood with a microscope, and it will be seen that the blood is simply a stream in which are floating, swimming, moving, and working, millions of little creatures so nearly like the microscopic creatures found in the scum of a stagnant pool that they have received the same name. The arteries and veins of the body may be looked upon as corresponding to the rivers and streams of a continent, and the blood corpuscles to the fish which swim in the waters. The Scale of Being. — Man must be looked upon as a part of the great world of life. He is not a distinct and wholly unique creation, totally unlike all other living forms. The little mass of protoplasm HOW PROTOPLASM WORKS. O 1 oJL which swims in a drop of stagnant water is at one end of the scale of being, and man, with his magnificent and wonderfully complicated mechanism stands at the other. The two are connected by an unbro¬ ken chain of living forms which rise in complexity and superiority in regular gradations from the living atom in the speck of green scum to the human form divine at the summit of the scale. The scale of life includes all living forms, not simply animals, as might be easily supposed. In all, protoplasm remains the same, al¬ ways apparently identical, yet sufficiently different to give to the forms of life which it helps to constitute, individuality of existence and characteristic properties. How Protoplasm Works. — See Figs. 1 to 8. There is nothing more interesting in all the realm of science than to watch with a microscope the operations of protoplasm. Let us study this wonderful phenom¬ enon for a few minutes. In anticipation of wanting material for such a study, a few weeks ago we pulled a handful of grass from the lawn in front of our office, and placing it in a platter half tilled with water, put it in a warm place. Now we bring out the platter and find that the grass has undergone partial decomposition. With a glass tube we draw up a few drops of the dirty-looking fluid in which the half de¬ composed grass is submerged, and placing a single tiny drop upon a clean slip of glass we put it in the focus of a powerful microscope. Adjusting the glass and the light perfectly, we soon see sundry shreds of brown grass, and numerous floating particles of dust and other for¬ eign matter of no particular interest. If we had not sought a similar view many times before, we should soon put aside the instrument and turn our attention to something more attractive ; but we have learned to look a little sharper, and now we are rewarded by seeing j ust what we were in search of, curious little round masses so transparent as to be almost invisible. They are not very numerous, but scattered here and there about the field. Presently we perceive that some are chang¬ ing their form. A moment ago the first one we inspected was as round as a watch crystal ; now it has become elliptical in form. A few minutes later we look again, and it has stretched itself out into a long filament like an angle-worm. Presently it begins to draw itself up into a round mass again ; and before we can write it, it has as¬ sumed its original shape, but has changed its position. rIhat is the way the little creature moves about. It makes itself into- the shape of a worm and then crawls just as a worm does, by making one end 32 ANATOMY, PHYSIOLOGY, AND HYGIENE. fast and drawing the rest of the body up. But what does it move about for ? "Why may it not remain stationary ? Shortly we shall see if we watch carefully. Even now the reason is evident. Reader, just peep over our. shoulder a moment. Put your eye down to the eye-piece of our microscope. Do you see the little fellow ? Look sharp, and you will. A few seconds ago it was round as a full moon. Now there is a little pocket in one side. The pocket is growing Fig. l. Fig-. 4. Fig:. 5. the centers are nuclei. Figs. 2, 3, and 4 show different varieties of cells. Figs. 5, 6, and 7, show how cells divide or multiply. Fig. 8 is a representation of the manner in which cells unite by their arms to form capillary vessels. deeper and deeper. "What is the object of such a curious procedure ? Let us put on another eye-piece. Now we have magnified the object a million times. See how much larger it looks. Now look at the pocket. The mystery is solved. There is a little speck of food which the little creature wishes to get, and so he has made a pocket to put it in. The queerest part is to come yet, so we must watch patiently a moment more. Now the mouth of the pocket is closing up. Evi¬ dently the little fellow is afraid he may lose the precious morsel, and INORGANIC AND ORGANIZED MATTER. 33 so he is going to shut the pocket to prevent its escape. Now the open¬ ing is closed, and before we are aware of it, the pocket itself has dis¬ appeared, and there is the little particle inside. This seems a miracu¬ lous process, but it is the peculiar way these little creatures have of taking food. When they wish to eat, they make a mouth or a stom¬ ach on purpose. If we wait a few minutes we shall see that the lit¬ tle particle taken in has disappeared. It has been digested. Thus the lowest forms of life can perform some of the same functions which higher animals and vegetables perform, but by much simpler processes. The smaller living creatures are, the more remarkable seem to be their powers. As we become better acquainted with protoplasm, it does not seem so strange after all that it should be capable of making a plant, painting a flower, building a tree, or even of forming a man ; and that is just what it does. How, we shall see further on when we study the various tissues of the body. Let us now consider some of the principal differences between inorganic and organized or living matter. Differences between Inorganic and Organized Matter.— Mat¬ ter that does not manifest life in any form is called inorganic ; living matter is said to be organized, because life depends upon organization. The following table exhibits the principal differences between these two forms of matter : — ■ INORGANIC MATTER. 1. Not alive. 2. Usually has angular outlines. 3. Has a crystalline structure. 4. Grows by accretion. 5. Does not reproduce itself. 6. Does not ferment or decay. ORGANIZED MATTER. Alive. Characterized by rounded forms. Has a cellular structure. Grows by assimilation. Reproduces itself. Ferments or decays. 1. Inorganic matter, such as sand, rocks, and all forms of mineral, earthy, and gaseous bodies and chemical compounds, never exhibit the peculiar phenomena which are commonly known as life. These phenomena are confined wholly to plants and animals. 2. Nearly all inorganic objects, unless artificially modified in form, have angular outlines, being usually bounded by straight lines. Or¬ ganized bodies are bounded by curved and graceful outlines. 3. Most inorganic bodies are crystalline in structure, or are made up of particles which at some time have been crystals. Organized bodies, on the other hand, are generally composed of cells. A cell 3 34 ANATOMY, PHYSIOLOGY, AND HYGIENE. consists of a mass of protoplasm, which is sometimes surrounded by a thin wall. 4. Inorganic bodies grow by accretion, that is, by additions to the outside, of matter of the same kind. The increase in size of a snow¬ ball is a good illustration of growth by accretion. Organized bodies, on the contrary, grow by assimilation, that is, by taking into them¬ selves, from the outside, matter of an unlike character and making it into their own kind of tissue. Thus, a plant grows by taking in food through its roots and leaves ; an animal, by taking food into its stom¬ ach, assimilation taking place in both. 5. Reproduction is a process wholly peculiar to organized beings. Stones never reproduce their kind. All organized bodies possess the power to create new beings like themselves. Reproduction is really a process of creation, and as such is the most wonderful of all the phenomena of life. 6. Fermentation and decay are processes by which a living organ¬ ism returns to the inorganic state, which is commonly known as death. As inorganic bodies do not possess life, of course they cannot lose it. The classification of all objects into inorganic and organized is not strictly correct, since this division does not include a peculiar class of substances not strictly belonging to either of the two mentioned, since it possesses some of the properties of each. These substances may be distinguished as organic. They are not organized since they have not a cellular structure, and are often crystalline ; yet they are man¬ ifestly not wholly inorganic, since they are subject to fermentation. Sugar, starch, fat, albumen, and sundry other substances which are generally known as proximate elements, belong to this class. Animals and Yegetables.— If we should scrape from the surface of an old watering-trough some of the slime which is commonly found in such places, and submit it to examination with the microscope, we should find it to be composed almost wholly of living creatures of al¬ most every imaginable form, possessing wonderful activity, and going through the various processes of life common to higher orders of liv¬ ing beings. Should the question be asked, Are these curious organ¬ isms animals or vegetables ? we might find it more difficult to answer than would be at first imagined. Very likely we should at first call them all animals, since they appear to be swimming about, seemingly possessing volition as distinctly developed as in fishes, birds, and larger animals. But a more careful study of the subject would DISTINCTIONS BETWEEN MAN AND BEAST. 35 show us our mistake. The general ideas regarding the distinctions between animals and vegetables hold good only regarding the higher orders of animals and vegetables. In the lower orders nearly all of these distinctions disappear. For example, it is generally supposed that animals alone possess the power of locomotion, vegetables remain¬ ing stationary wherever they happen to begin their growth. This is not true with the ly a ligament to the upper part of the leg bone, or tibia ; and the sartorius, or tailor’s muscle, which is used in crossing the legs beneath the body when sitting down in tailor fashion. Muscles of the Foot. — The ankle and toes are moved by twenty separate muscles, of which we will only mention the gastrocnemius and soleus which form the chief part of the calf of the leg. There is much less freedom of motion in the digits of the feet than in those of the hand, although the number and relations of their muscles are much the same. A considerable desree of control over the toes can be ob- O tained, however, by practice, as is shown in the case of persons who, being deprived of hands, have learned to write legibly with their toes. PHYSIOLOGY OF THE MUSCLES, The sole property of a muscular fibre is contractility. Muscular fibres are said to possess a natural irritability by means of which they respond to proper kinds of stimulation by contracting. The ordinary and most natural stimulus to muscular contraction is nerve force. Through the connection of the nerves with the muscles, nerve force generated in the living batteries of the system — the nerve cells of the brain and spinal cord— is communicated to the muscle fibres, which are by this means made to contract. Muscular fibres may also be made to contract by the stimulus of electricity, which in many respects very closely resembles the nerve force. Mechanical and chemical irritation, such as striking, tearing, or pinching the muscle, or applying an acid or some other irritant, has a similar effect. It was formerly supposed that muscles could be made to contract only through the medium of nerves. It is now known, however, that this view is incorrect, since by direct irritation muscular contraction can be produced when the nerves are completely paralyzed. HOW A MUSCLE CONTRACTS. 85 The contractile power of muscular fibres is not only always pres¬ ent while they retain their life, hut is always active. Contrary to the general supposition, the muscles are never quiet. They are always actively at work, and it is by means of this constant contraction that the symmetry of the body is preserved. A proof of this is found in the fact that when a single set of muscles is paralyzed, the part be¬ comes distorted by the contraction of the antagonizing muscles. This is often seen in the face in cases of paralysis of one side. A short time ago we had under treatment a patient in whom the extensor muscles of both fore-arms had been paralyzed, so that there was loss of power to straighten the hands. The fingers were all bent toward the palm. The patient could lift quite a heavy weight, but could not open the hand, and could scarcely move a finger except to close it tighter. By the application of proper treatment to the paralyzed muscles upon the outer side of the arm the patient recovered the power to control the hand and straighten the fingers. This peculiar property is called muscular tonicity. How a Muscle Contracts. — The contraction of a muscle, though very simple, is still interesting. If the arm be clasped with the hand, and the fore-arm be then bent, the hand being closed and a consider¬ able degree of force exerted, as in lifting a heavy weight, it will be observed that the arm becomes larger, seeming to swell out beneath the grasp. If a single muscular fibre were under examination be¬ neath a good microscope, as a live fibre just taken from a frog or a turtle, we might cause it to contract by a very feeble current of elec¬ tricity ; and should we do so, we should notice essentially the same thing ; we should find that the fibre would become thicker, but at the same time it would become shorter. As already explained, a muscle is made up of a large number of fibres ; and its contraction as a whole is due to the contraction of each one of the minute fibres which compose it. As each one of these thickens and shortens in the process, the whole muscle thickens and shortens. There is no increase in size in the muscle, but simply a change of form. This is the simple manner in which all motion is produced. Mechanical Action of Muscles. — As elsewhere remarked, the muscles use the bones as levers in executing their various movements. Not only the lever but also the pulley, another mechanical power, is illustrated in the action of the muscles. It will be both interesting and profitable to notice some of these exhibitions of vital mechanics. 86 ANATOMY, PHYSIOLOGY, AND HYGIENE A lever consists essentially of a rigid bar of some sort, a point of rest for the bar, which may be at one end or at any point between the ends called the f ulcrum, the pow- er, which is applied to some part of the lever away from the ful¬ crum, and the weight, the object to be lifted. There are described three kinds of levers, which are illustrated in Figs. 46, 47, 48. In the first kind, it will be noticed that the weight is upon one side of the rest, or fulcrum, and the power on the other side. In the second kind of lever, shown in Fig. 47, the weight is between the power and the fulcrum. In both instances there is a gain of power, because the force is applied at the long arm of the lever. In the third class, Fig. 48, the power is between the weight and the fulcrum. Now the power is applied at a disadvan¬ tage, as the weight is at the long arm of the lever. However, there is compensation; for what is lost in power is gained in speed or motion. Now, regarding the muscles as the power, the bones as the levers, the work to be done, that is, the objects to be lifted, carried, pushed, or oth¬ erwise moved by the muscles, as the weight, let us see how these different in the human body. The first kind of lever is rarely illustrated in the body. It is found, however, as in the action of the muscles of the back of the neck upon the head. The top of the spinal column is the fulcrum, the head itself the leva’, the muscles of the neck the power, and the front part of the head the weight to be lifted. Illustrations of the other two kinds of levers are very abundant. In the foot, employed in the ordi¬ nary act of walking, we have a good illustration of a lever of the second class. When the body is supported on tiptoe, the foot is the lever, the earth the fulcrum, the body the weight, and the muscles of the calf the power. See Fig. 49. USES OF MUSCLES. 87 Fig. 50 illustrates by the arm a lever of the third class. Here the fore-arm is the lever, the elbow is the fulcrum, the muscles of the fore-arm the power, and the dumb-bell lifted in the hand the weight. The power, being applied between the fulcrum and the weights, lifts the ball at a disadvantage, as it evidently re¬ quires more strength to hold the ball in posi¬ tion as shown in the figure than it would to lift it straight up with the arm by the side. It is not a mistake of nature that the muscles and bones of the arm are so arranged that the power is applied at a mechanical disadvantage, since what is lost in lifting power is gained in rapidity and extent of motion. By means of this arrangement the dexterity of the hands is very greatly increased, and they are far better .. Fi8’’ 49' In the ?bov,e cut J J J the foot, c, represents a lever fitted for the great variety of rapid movements with the fulcrum at r, the . n , , ,, , , weight of the body lifted which they are required to execute than they through the bones of the leg, could otherwise be. joining the foot at W, and the power applied at P, the The pulley principle is beautifully and per- heel, through the contraction n the smaller portion, located in the back and lower part of the skull, is called the Fig. 72. The left half of the brain, showing the convolutions of the cerebrum, one lateral ventricle, the arbor vital of the cere¬ bellum, etc. THE CEREBBO-SPINAL SYSTEM. 119 cerebellum , or little brain. Each of these principal portions of the brain is subdivided by a fold of the mem¬ branous coverings into two lateral halves, each of which furnishes nerves to the opposite half of the body. When the membranes of the brain are removed, its surface is found to be marked by numerous and quite deep depressions, which are due to the convolutions or fold¬ ings of its outer layers. The gray color of the mass is also noticeable. When cut, it is found that the gray substance extends but a little way into the mass of tissue, the central portion being white. Examination with a microscope shows that the gray substance is composed of nerve cells, while the white portion is made up of fibres, which are connected with the cells. At the base of the brain, or its under side and cen¬ tral portion, are found a number of collections of gray matter or nerve cells, called the central ganglia of the brain. At the lowest portion of the brain, just at its junction with the spinal cord at the foramen magnum, Fig-. 74. A view of the Cranial Nerves, with their points of origin in the brain. known as the is a rounded body, Fig-. 73. A horizontal section of the brain through its middle portion, showing the rela¬ tion of the white matter to the gray, with many other points of interest. 120 ANATOMY, PHYSIOLOGY, AND HYGIENE . medulla oblongata, which may really he considered as the enlarged upper end of the spinal cord. In the central portion of the brain is found a curious little organ about as large as a pea, the pineal gland, which the great philosopher Descartes supposed to be the seat of the soul. It is now known to be simply a gland. From this exceedingly brief description it will be seen that the brain is really a collection of ganglia within the skull, and consists of sev¬ eral distinct groups of cells. Each group has its particular function to perform, its particular part of the work of the vital economy to control or direct. From each one go out nerve fibres which terminate in different ways, according to the functions to be performed. The Spinal Cord . — The spinal cord, or marrow, as it is sometimes called, is really a continuation of the brain down through the spinal canal. It extends through the whole length of the canal, and at its lower extremity spreads itself out like the tail of a horse, whence it is in this region called the cauda equina. The spinal cord is really a series of cell groups, or ganglia, ranged one above another, but so closely joined together as to make them practically inseparable. Like the brain, the cord is invested by membranes designed for its protection and nourishment. Like the brain, also, it is divided into two lateral halves, each half being further divided into anterior and posterior col¬ umns. All along its course the cord sends off branches, which have two roots, one of which arises from the anterior column, and the other from the side of the cord, branches being sent off symmetrically from both sides. The Cerebro-Spinal Nerves. — The nerve branches which are sent out by the brain and spinal cord number forty pairs in all, of which nine pairs originate in the brain, and thirty-one in the spinal cord. See Figs. 71 and 69. The thirty-one pairs of nerves which are derived from the spinal cord are distributed chiefly to the trunk and extremities, all parts of which they supply with nerves of sensation and of motion. The nine nerve branches from the brain, arising chiefly from the central gan¬ glia at its base and from the medulla oblongata, are distributed to the face, the organs of special sense located in the head, and the vital or¬ gans of the chest and abdomen. The manner in which nerves and nerve cells are connected is now pretty well understood, though it has been but recently that the exact THE SYMPATHETIC SYSTEM OF NERVES. 121 mode of connection has been determined. It will be recalled that nerve cells are provided with peculiar appendages, some possessing but one, others two, three, or even as many as a dozen or more. It ap¬ pears from careful investiga¬ tions that have been made of this subject that these poles or branches are for the purpose of connecting to¬ gether individual cells ; and also, that nerve fibres are simply prolongations of these same appendages. By this means the minute cells of the brain and spinal cord are actually extended into the most remote portions of the body ; and the millions of cells which make up the gray matter of the brain and cord are connected by the same means. The Sympathetic or Or gaiiic System of Nerves. — Fig. 75. This system is made up of a series of small ganglia found in the head O O and on either side of the spinal column within the cavities of the trunk. The ganglia are all connected by small fibres, so that they are sometimes spoken of as being a single nerve, the great sympathetic. Their fibres follow the blood- ves- *ie- 75- , A of the Sympathetic or Organic Nervous System. sels in great numbers, start¬ ing with them as they go out from the heart. A large collection of the nerves of this system, found in the abdomen just back of the stomach, is known as the solar plexus- This system is closely con- 122 ANATOMY, PHYSIOLOGY, AND HYGIENE. nectecl with the cerebro-spinal system of nerves by means of commu¬ nicating branches. General Properties of Nerves. — Nerves possess, during life, the power to do two things : to conduct nerve force, and to conduct im¬ pressions received from without. Both these properties are not pos¬ sessed by the same nerve fibres at the same time. For doing the two kinds of work there are two classes of nerves. They do not differ in the least in structure, but totally in function. One carries impressions into the brain and spinal cord ; the other transmits nerve force in the form of impulses outward. As there are many varieties of impres¬ sions to be received, there are several kinds of nerves which have power to transmit impressions only of one certain kind. These are called nerves of special sense. This property of nerves is known as nervous irritability. Each nerve of special sense possesses only its own kind of irritability. For instance, the nerve of sight transmits impressions of sight, but not of hearing, smell, taste, or any other kind of impression. So with each of the others. The nerves which travel outward from the nerve centers end in the muscles, — where they are called motor nerves, — in membranes, glands, and in all parts requiring the aid or control of the nerves. PHYSIOLOGY OF THE BRAIN AND NERVES. The chief organ in the nervous system is the brain. This is the great center from which emanates the nerve force which vitalizes and energizes every part of the body. It is the seat of government in the vital domain, the nerves being its servants through which it receives information of the external world, and by means of which it is able to execute its mandates in all parts of its province, even extending be¬ yond itself and the limits of the body, and operating upon external things through the medium of its instruments. As before stated, the brain is made up of a series of ganglia, each of which has special duties to perform. We can only understand the functions of the brain as a whole by studying the functions of each of the separate groups of cells which compose it. This has been done with the greatest care, and very recently results have been obtained which throw great light on this hitherto most complex and mysteri¬ ous subject. So far as we know, these results have not yet been em¬ bodied in any treatise on the subject, being only to be found in sci- FUNCTIONS OF TIIE MEDULLA OBLONGATA. 123 entitle periodicals. An eminent writer* in a leading English scien¬ tific magazine, the Nineteenth Century, has summarized these late re¬ sults so admirably and succinctly that we cannot do better than to quote a portion of his article, as follows : — “ The most important step in modern research, and which may be said to have ushered in a new period in our knowledge of brain func¬ tion, was the application of electricity to the hemispheres of the brain of living animals, and the observation of the effects caused by such stimulation. The first successful experiments of this kind were made by two German observers, Fritsche and Hitzig, of Berlin, who were soon followed by Ferrier in this country. A secure base was thus given to one of the most important doctrines of the present day, viz., the localization of the several cerebral faculties ; and if vivisection had done nothing else for science, it would simply on account of this have a claim on our gratitude. But vivisection is only one of the means which have been employed toward the elucidation of our subject. The clinical features of the several diseases of the brain have been, and are now, more attentively than ever studied by hospital physi¬ cians ; the symptoms observed during life are compared with the re¬ sults of post-mortem examinations ; and by simultaneously bringing anatomy, experimental physiology, clinical medicine, and pathology to bear upon this gTeat question, the present doctrine of brain-function eventually became established. Functions of tlie Medulla Oblongata.—" We may subdivide the brain into five principal parts, which greatly differ in general configu¬ ration, and which, although they are in the most intimate connection with each other, yet are invested with thoroughly different functions. They stand in the relation of higher and lower centers, the lowest be¬ ing the medulla, and the highest the gray surface of the hemispheres. The functions of these parts will now be considered seriatim, begin¬ ning with the lower centers. “ 1. The medulla forms the connecting link between the spinal cord and the brain. It is a small cord, about an inch long, and weigh¬ ing no more than two drachms ; yet it must be looked upon as the most vital part of the whole system, for injury to it proves immedi¬ ately fatal. The most important function of the medulla is to cause and to regulate the respiratory movements, and the point in which *Dr. Julius Althaus. 124 ANATOMY, PHYSIOLOGY, AND HYGIENE. this respiratory center is situated is called the vital knot. Death by hanging results generally from injury to this special point in the me¬ dulla, through dislocation or fracture of the upper portion of the spine ; the criminal therefore dies of asphyxia, or cessation of respira¬ tion. The entire brain above the medulla may be removed in an ani¬ mal, and the latter may yet continue to breathe ; but destruction of the medulla asphyxiates it at once. The same organ also regulates the heart’s action. It is true that the pulsations of the heart are not, like the respiratory movements, at once arrested by destruction of the medulla, for they may continue for some time after death from hang¬ ing. Indeed, the rhythmic beating of the heart is effected by means of small nerve cells which are situated in its muscular substance, and which may retain their energy for some time after death. The influ¬ ence of the medulla upon the heart is therefore a secondary one, that is, to retard or accelerate its action. The medulla is never at rest as long as life lasts; for respiration and the heart’s action continue during sleep as well as in the waking condition in a typical manner. “ The medulla is likewise the center of action for the blood-vessels. These are not always equally distended by the circulating liquid, but may contract and dilate, as is seen in sudden blushing and pallor, un¬ der the influence of diverse mental emotions. The insensible perspira¬ tion of the skin, which, like respiration, is also going on constantly, is likewise under the influence of the medulla. “ A pointed illustration of these facts is given by the symptoms of the peculiar disorder known as sun-stroke. This affection occurs more particularly in the tropics, but is occasionally observed in hot weather in the temperate zone, in persons who are exposed to the direct rays of the sun, and who have at the same time to undergo exertion. It is therefore chiefly seen in soldiers marching during the heat of the day, or in agricultural laborers who are at work in the fields ; yet it has been known to come on at night, in persons sleeping in the pestilential atmosphere of overcrowded and badly ventilated barracks or cabins, and in children shut up in a stifling bedroom after having been ex¬ posed to great heat during the day. It would therefore be more ap¬ propriate to speak of heat-stroke, for the disorder really consists of a great and sudden rise in the temperature of the blood, which in this state acts as a poison on the medulla. The perspiration of the skin is suddenly arrested, and as the evaporation of sweat on the surface of the body is intended to produce cold, and thus to neutralize the effects FUNCTIONS OF THE MEDULLA OBLONGATA. 125 of the external heat, the closure of this safety-valve causes a further' rise of temperature, which paralyzes some or most of the centers in the medulla. The worst kind of heat-stroke is that in which the cen¬ ters for respiration and the heart’s action are affected, as fatal asphyxia or syncope is the result. A person who may be walking in the street or working in a field is seen suddenly to drop down as if shot or struck by lightning, and dies in a minute or two. A fatal issue is in such cases so rapid that there is no chance for any treatment to do good, more especially as the means which would be of the first im¬ portance, viz., ice and plenty of cold water, are usually not at once at hand. “ The second kind of sun-stroke is owing to paralysis of the center for the blood-vessels in the medulla, whereby apoplexy is caused. In such instances the symptoms are not quite so sudden, and death may often be averted. The illness begins with mental disturbance — there are delusions and hallucinations, followed by mania, and the patient may commit suicide or homicide. This stage of excitement lasts for a short time, and is succeeded by a period of depression. The patient becomes sleepy, insensible, and may die in a state of profound apo¬ plexy. Life is, however, often saved by drenching the body with cold water, and applying ice to the head. The overheated blood is thereby cooled, and the medulla roused from its torpid condition. The movements of swallowing, which require for their proper ex¬ ecution a co-ordinated action of the lips, tongue, palate, and gullet, are likewise under the immediate influence of the medulla. The same or¬ gan contains a center for the physiognomical play of the muscles of the face, and another for articulate speech, that is, the pronunciation of vowels and consonants in such fashion as to form words. These facts are well illustrated by the symptoms of a peculiar disease which, although it has no doubt always existed, has only recently attracted the attention of the medical world, and which consists in a wasting away of those nerve cells in the medulla which preside over the func¬ tions just mentioned. This affection, which has received the eupho¬ nious name of f labio-glosso-pharyngeal paralysis,’ commences with ap¬ parently insignificant symptoms. It is found that speaking, eating, and swallowing require an effort. The tongue feels heavy ; the lips do not move properly ; the patient experiences difficulty in pronounc¬ ing certain letters, such as b, p, o, and u ; he cannot whistle or blow out a candle. As time goes on, the tongue becomes more powerless ; 12G ANATOMY, PHYSIOLOGY, AND HYGIENE. more letters of the alphabet are lost ; the soft palate does not act properly, and the voice acquires a nasal twang. The vocal cords be¬ come paralyzed, the voice is completely lost, and the patient is only able to grunt. He cannot blow his nose, clear his throat, cough, or swallow. In attempting to eat, the tongue fails to form a proper morsel of the food taken, and to push it on to the gullet. The food remains, therefore, between the teeth and the cheeks, and can only be pushed farther on to the throat by the aid of the fingers. It is apt to get into the windpipe and cause choking. On attempting to drink, the liquid returns through the nose. The unfortunate sufferer thus dies a slow death from starvation, the torments of which can only in¬ adequately be relieved by medical aid. On making a post-mortem examination, wasting of certain nerve cells in the medulla is discov¬ ered to be the cause of this terrible malady. “ All these different functions of the medulla which we have con¬ sidered are automatic or mechanical, that is, independent of volition, intelligence, or any other of the higher mental processes ; and they may therefore continue where the higher centers in the brain have been either experimentally removed, or disorganized by disease.” Functions of the Pons and Optic Lobes.— “ 2. The next great division of the brain which we have to consider consists of the pons, or bridge, and optic lobes, and is the center for still more complicated ac¬ tions than those over which the medulla presides. The functions of these parts have been chiefly made known by experiments on living animals. A pigeon which is left in possession of these parts, but from which the higher portions of the brain have been removed, is still able to respond to a stimulus, but, if left alone, will show complete indiffer¬ ence and loss of initiative. There is no desire, no impulse to any spon¬ taneous action, and apparently no recollection of any former events. Such an animal will remain, day by day, sitting quietly on its feet, with¬ out giving any signs of life, and, unless artificially fed, will ultimately die of starvation, without feeling the pangs of hunger and without suf¬ fering in any way. As soon, however, as its repose is disturbed, it will give signs of life. If laid on the back, it will struggle until it has re¬ gained its previous position on the feet. If pinched, it will walk away. If thrown into the air, it will flap its wings, and come down to the ground in the ordinary manner. If a light be held to the eyes, the pupils will contract. If ammonia be applied near the nostrils, the animal will draw back with signs of disgust. If a shot be fired close FUNCTIONS OF THE PONS AND OPTIC LOBES. 127 to it, it will jump up and open its eyes ; and if food be put into its mouth, it will swallow it. “ In frogs and fishes the phenomena are almost identical with those observed in pigeons, being only slightly modified by the different me¬ dia in which the animals live. In the fish, for instance, the contact with the water acts as a constant external stimulus on the mechanism of swimming. A fish from which the higher portions of the brain have been removed, will therefore not sit still, like the pigeon, but will go on swimming until it reaches an impediment to its pas¬ sage. It follows a headlong and apparently irresistible impulse, yet will show some method, inasmuch as it will avoid obstacles, and turn aside when prevented from going straight on. While a fish in its nor¬ mal condition will, as may daily be seen in an aquarium, stop on its way, sniff about, pursue a prey, etc., the unbrained fish sails heed¬ lessly along, without ever stopping or taking nourishment, until it dies of exhaustion. In a similar manner an unbrained from when thrown into the water, will move on until it reaches terra Jirma, but, as soon as it has found a resting-place, will remain in the same state of death-like repose as the pigeon. “ In the mammalia the results differ somewhat from those obtained in the lower animals. In them the different portions of the brain are so intimately connected, and so dependent upon one another, that re¬ moval of the higher parts appears to disorder the entire mechanism, and causes such a degree of exhaustion as to interfere greatly with the independent action of the lower centers. Nevertheless, the functions of these latter are identical with those of the same parts in the lower animals, which we conclude from their homologous structure, and also from observations made in disease of these centers. “ The expression of the affections, such as fear, terror, pleasure, pain, etc., is likewise under the influence of the second division of the brain. Frogs, in which the higher portions of the brain have been destroyed or removed, will still croak when stroked across the back ; and croaking in the frog is the expression of satisfaction and comfort. In ourselves, laughing and crying, and othe'r expressions of the affec¬ tions, are generally quite involuntary, and independent of reflection. It is true, that we may, by an effort of the will, restrain or inhibit such expressions ; but this is done by a special exertion of the inhib¬ itory influence of the higher centers, which can only come into play after a long course of training, and which is quite absent in children and uneducated persons.” 128 ANATOMY ; PHYSIOLOGY , *4 AT) HYGIENE. Fimctious of the Cerebellum. — “ 3. The cerebellum , or little brain, which is intimately connected with the preceding and following divisions, was formerly believed to be the seat of the reproductive faculty and desire ; but this view has recently been shown to be in¬ correct. Nor has the cerebellum anything to do with reason, volition, or consciousness ; for animals which are deprived of the higher cen¬ ters, yet left in possession of the cerebellum, do not show any spon¬ taneity of desire or action, and will, for instance, die of starvation with the utmost indifference. If, however, the cerebellum be re¬ moved, the animal will move about as if it were drunk. It is not paralyzed, and will endeavor to carry out certain movements, but there is an utter want of precision ; and even the most desperate ef¬ forts do not succeed in steadying the body. The cerebellum is thus shown to be the organ of equilibration of the body ; and this conclu¬ sion from physic logical experiments has been corroborated by observa¬ tions of disease of the organ in man. It is likewise known that the different portions of the cerebellum have different parts allotted to them in this respect. One part prevents us from falling forward, an¬ other from falling sideways and from constantly turning round in a circle, while a third is intended to secure us from falling backward.” Functions of the Central Ganglia. — “4. The central ganglia, which constitute the fourth great division of the brain, have the func¬ tion to render certain complex movements which are intimately con¬ nected with sensations, and which are, in the first instance, only ex¬ cited by volition and consciousness, gradually, as it were, mechanical and automatic. The object of this contrivance is to save time and trouble to the highest portion of the brain, viz., the gray surface of the hemispheres. It is intended that these latter should only be oc¬ cupied with the most important manifestations of life. The central ganglia may therefore be said to be the confidential servants or pri¬ vate secretaries f the hemispheres, and undertake a good deal of drudgery, in order to leave the gray surface at liberty for the finer and more difficul inds of the work which falls to our lot in life. Thus we have, in childhood and youth, to learn the actions of walk¬ ing, talking, writing, dressing, dancing, riding on horseback, decent eating and drinking, singing, playing of musical instruments, etc., by countless conscious efforts on the part of the hemispheres ; and full attention is necessary in the beginning in order to enable us to carry out such movements in a proper manner. But the older we grow, the FUNCTIONS OF THE CENTRAL GANGLIA. 129 more frequently we have directed our minds to all these forms of ac¬ tivity, the less effort will eventually be necessary on the part of con¬ sciousness and volition ; and ultimately all such movements will be performed mechanically, and without much, if any, attention to them on the part of the gray surface of the brain. A man who is in the habit of writing much never thinks of the way in which he forms his letters on the paper, over which his pen seems to fly quite mechanic¬ ally. The same holds good for the various kinds of needlework, em¬ broidery, playing on the piano, the violin, etc. If, each time we do any¬ thing of that sort, a conscious effort were necessary for all the differ¬ ent parts of which the action is composed, the time at our disposal would not suffice for the hundredth part of the work which we actu- ally get through in life ; and some forms of activity, such as finished piano and violin playing, would be utterly impossible. “ A key is thus furnished for the comprehension of many singu¬ lar occurrences which would otherwise be quite inexplicable. A pian¬ ist, for instance, finds himself playing one of Rubinstein’s sonatas by heart, and is perhaps thinking all the time of his coming trip to Switz¬ erland, or something else which may happen to engage his attention ; that is, the central ganglia play the sonata, while the hemispheres are busy elsewhere. A very worthy country parson told me some time ago that, when he reads prayers at church, he does so quite as an automaton, for his mind keeps wandering in a totally different direction. A man who knows London well may walk from his house through a maze of streets with the greatest precision to his club, where he arrives without having given the slightest attention either to the act of walking or to the direction he took, but having been quite in another world of thoughts all the time he was on his way. “ Somnambulism and other automatic conditions, which are observed in certain states of derangement of the nervous system, may be similarly explained. The lower centers are habitually under the absolute control of the highest, that is, the hemispheres ; yet this balance of power may be temporarily disturbed by illness or exhaustion of the gray surface, and the central ganglia may then begin to act in their own fashion. What may take place under such circumstances may be aptly compared to certain occurrences which are not uncommon when the family is out of town, and the servants are left in charge of the house. Supposing the hemispheres to have lost their control over the lower centers, elabo¬ rate actions may take place which may have all the appearance of delib- 9 130 ANATOMY, PHYSIOLOGY, AND HYGIENE. erate intention, and yet for which the person who commits them can no more he held responsible than the absent master of the house for the mis¬ doings of his servants. The somnambulist who falls from the roof of a house and is killed is no more a suicide than a man who in the state of epileptic vertigo commits robbery, arson, or murder, can be called a truly responsible criminal. The legal mind has not yet been able to grasp the full significance of these facts, as shown by convictions to penal servitude of persons who should have been sent to hospitals or asylums.” Functions of the Cerebrum. — “5. The highest development of brain-matter is found in the hemispheres, convolutions, or gray surface of the brain, which is the material base of all mental and moral activity. This portion of the brain ***** is not a single organ, as was formerly supposed, but consists of a number of thoroughly differentiated organs, each one of which possesses certain functions, yet is in the closest possible connection with all the others. To define all these various organs with accuracy, to determine their inti¬ mate structure as well as their individual energy, and to trace the phys¬ iological and pathological alterations which they undergo during the natural processes of development, maturity, and decay, and in diseases to which they are subject, is the greatest problem for the anatomy and physiology of the twentieth century ; and when this problem is solved, a complete revolution in psychology must be the result. At present, however, we are only on the threshold of this inquiry, which is perhaps the most difficult and complicated of any which may present themselves to the human mind. “ I cannot attempt, in the limits of the present paper, to enter at all fully into the labyrinth of these convolutions, but must be satisfied with a rapid survey of what is best known with regard to the functions of some of them. One of the most suggestive results of recent researches has been to show that the faculty of intelligent language, as distinguished from simply articulate speech, is situated in that portion of the hemi¬ spheres which is called the third left frontal convolution, and its imme¬ diate neighborhood. We have already seen that the pronunciation of letters and words is effected in the lowest portion of the brain, viz., the medulla ; but this and all the other inferior organs concerned in speak¬ ing form only as it were the instrument, on which that small portion of the brain’s surface which I have just named is habitually playing. Lower centers are able to hear spoken words, and to see written words ; but the intelligent appreciation of the connection which exists between FUNCTIONS OF THE CEREBRUM. 131 words and ideas, and the faculty of expressing thoughts in sentences — that is, what the Greeks called logos — only resides in the third left frontal convolution. This discovery was foreshadowed by Gall, hut actually made by Broco, who likewise found that the left hemisphere is altogether more important for intellectual manifestations than the right, and is chiefly trained for talking as well as most of the finer kinds of work which we have to perform in daily life. This appears to be owing to the following circumstances : The left hemisphere is originally heavier than the right ; the convolutions are more abundantly developed in the left ; and finally, the left is more abundantly provided with blood, on account of the larger caliber of the blood-vessels which supply it. Most people therefore train chiefly the left hemisphere for talking, writing, etc. ; they are left-brained as they are right-handed. A preponderance of the right over the left hemisphere, on the other hand, seems, accord¬ ing: to the most recent researches, to be characteristic of certain forms of insanity. “ Physiological experiments on animals point to the convolution I have just named as being concerned in language; for when electricity is applied to the part in the living monkey or rabbit, the animal opens its mouth, and alternately protrudes and retracts the tongue. But far more convincing proofs have been furnished by numerous cases of dis¬ ease in which there was loss of language during life, and where after death a lesion limited to the part just named was discovered. “ A boy, aged five, who was a great chatterbox, fell out of the win¬ dow and injured the left frontal bone, which was found depressed. There was no paralysis, but the boy had entirely lost his language. The wound healed in twenty-five days ; but the child, although intelligent, remained dumb. A year afterward he was accidentally drowned, and at the autopsy it was found that the third left frontal convolution had been destroyed by the inj ury he had received. “ A man fell with his horse, but got up, took hold of the reins, and was going to jump into the saddle, when a doctor who happened to ac¬ company him expressed the wish to make an examination. It was then found that he could not speak, but had to make himself understood by pantomime. A small wound in the left side of tne forehead v as found, with depression of bone ; but there was no paralysis. Inflammation set in, the patient died, and at the post-mortem examination it was found that a fragment of bone had penetrated into the third left fiontal con¬ volution, which had become softened. 132 ANATOMY, PHYSIOLOGY, AND HYGIENE . “ Talking, writing, drawing, etc., are habitually done by the left hemisphere alone, while both hemispheres have to be trained for musical performances. Pianists educate them both equally, while violinists and violoncello-players have to train them dissimilarly ; and this is probably the reason why it requires more practice, and is more difficult, to play well on string-instruments than on the piano. “ A man who has by disease or injury lost the faculty of talking, is generally also unable to write ; and it is only in exceptional cases that one of these functions persists while the other is in abeyance. Cases of this latter kind show, however, that there are really two separate centers for the two faculties which are lying very close together, and there¬ fore generally suffer at the same time. If the disease affecting them be still more extensive, the faculty of intelligent pantomime or gesticulation is likewise abolished. Persons who have entirely lost their language may still be able to play chess, backgammon, and whist ; and they have been observed to cheat at cards with some ingenuity ; they may also be sharp in business matters, — facts tending to show that speech and intellect do not run in identical grooves. “ Those portions of the hemispheres which correspond to the pareital region or crown of the head, and which are called the pareital lobes, constitute the true motor region of the brain’s surface, and, being in in¬ timate connection with another portion which is the material base of the intellect and mind, have been called psycho-motor centers, in order to distinguish them from the lower motor centers in the medulla, the cen¬ tral ganglia, etc. The special functions of these psycho-motor centers have been studied by the application of electricity, by destroying them in the living animal, and also by observation of certain symptoms at the bedside ; and it has been shown that each one singly serves some defi¬ nite purpose, as, for instance, clenching the fist, swimming, grasping something, raising the hand to the mouth, etc. Destruction of these centers causes paralysis of such movements, while irritation of them leads to a peculiar form of epilepsy, in which the convulsions affect only one (the opposite) side of the body, and where there is generally no loss of consciousness. “ The next great division of the brain’s surface is that which cor¬ responds to the temporal region of the skull. These temporal lobes of the hemispheres are intended to act as centers for sensory percep¬ tions. This is likewise shown by galvanizing them in the living ani¬ mal, and by localized destruction of the same. One portion of the FUNCTIONS OF THE CEREBRUM. 133 temporal lobe is the center of the sense of hearing. If it be de¬ stroyed, deafness on the opposite side is the result ; on the other hand, if it be electrified, the animal is seen to prick up its ears and to as¬ sume the attitude of listening, just as it does when a sudden noise is made close to its ear. In those animals whose habits of life render their safety dependent upon the keenness of their sense of hearing, as, for instance, the wild rabbit and the jackal, galvanization of that part causes not only pricking of ears and listening, but also a quick jump to the side, as if to escape from some danger which would be announced by a loud or unusual noise. “ The center for the sense of smell is situated close by. If it be electrified, the animal begins to sniff, as if it smelt something strong, just as it does when odoriferous substances are placed to its nose. De¬ struction of this center causes loss of smell. It is particularly devel¬ oped in animals which are endowed with a keen sense of smell, such as dogs, cats, and rabbits. A center for the perception of taste is in its immediate neighborhood. Other portions of the temporal lobes are intended for the sense of touch, and there is also a visual center, de¬ struction of which causes blindness of the opposite side. All these centers are symmetrically arranged on both sides, the left in the brain serving for the right side of the body, and vice versa. “ A third portion of the hemispheres which we have to consider are the posterior or occipital lobes, which correspond to the back of the head. Their structure differs greatly from that of the parts more in front, and they receive their blood supply from quite a different set of blood-vessels. Electricity has apparently no influence upon them, and destruction of their substance causes neither paralysis nor loss of sensation. Animals from which these lobes have been removed con¬ tinue to see, hear, touch, taste, smell, and move about just as usual. They generally, however, refuse to eat, and succumb rapidly. W e are inclined to look upon these lobes as specially connected with the digestive tract, more especially the stomach and liver, and also with the reproductive organs ; yet the symptoms of disease of these lobes are contradictory and perplexing, and our knowledge concerning them is as yet in its infancy. “The last and most important portion of the hemispheres consists of the anterior or frontal lobes, which correspond to the forehead. They are the actual seat of the intellect. Injury or disease of these lobes does not cause any impairment of motion or sensation ; and large 134 ANATOMY, PHYSIOLOGY, AND HYGIENE. portions of brain-matter have occasionally been lost through wounds in these parts without any very striking symptoms, such as paralysis, etc., following, more especially if the lesion was confined to one side. Patients have now and then recovered from the most fearful injuries to the anterior lobes, and yet been able to go about and to attend to the ordinary routine of certain occupations ; but it has always been shown, on close examination, that there had been a profound change in the character and behavior of such persons, and that their temper and their mental and moral faculties had become deteriorated. In a very marked case of this kind, which occurred some years ago in a previously steady and clever workman, there was, after recovery from the injury, such a change in the mind of the man that his em¬ ployers had to discharge him. The balance between his intellect¬ ual faculties and his animal propensities had evidently been de¬ stroyed. He had become capricious and vacillating, fitful, impatient, obstinate, and, as far as intellectual capacity was concerned, appeared to be a child, which, however, had the animal passions of a strong man. In consonance with such cases is Ferrier’s experience with monkeys in whom he had destroyed these lobes. The animals did not appear to have lost the power of motion or sensation, but there was ail alteration in their character. While previously to the operation they were actively interested in their surroundings, and pried into everything which came within their sphere, they had after it become dull and apathetic, readily dozed off to sleep, or wandered to and fro in a listless manner ; so that it was evident that they had lost the faculty of attentive and intelligent observation. “ The anterior lobes have therefore to be looked upon as the or¬ ganic base of the highest intellectual and moral faculties. The prin¬ cipal part of the work done in life consists of certain movements or’ actions, which are the more or less immediate consequence of sensa¬ tions and desires which we experience ; but apart from the power of performing such actions, we possess the faculty of restraining or in¬ hibiting them in spite of being urged to their performance by sensa¬ tions or desires. This inhibitory action is again most intimately con¬ nected with the power of concentrating attention, without which none of the higher intellectual operations are possible. The anterior lobes are therefore inhibitory centers, intended for the highest kind of mental work and moral control. They are small in idiots and the lower animals, larger in monkeys, largest in man ; and their pecul- FUNCTIONS OF THE SPINAL COED. 135 iarly large and abundant development is found to coincide with the highest development of intellectual power. “ It is probable that a special evolution of certain parts of these lobes will be found to coincide with the presence of certain special apt¬ itudes and talents in individuals ; but of this nothing definite is known, and there is in this direction an immense field still open for patient and intelligent inquiry.” The Functions of the Spinal Cord.— The spinal cord contains both gray and white matter, the gray matter consisting of nerve-cells and the white matter of nerve fibres. The function of the nerve- cells seems to be to have charge of certain automatic movements which are performed independent of the will, or involuntarily. These move¬ ments are generally termed reflex, since they are supposed to originate in external impressions which cause an impulse to be carried to the spinal cord by a sensory nerve, the impulse being reflected to the muscles by a motor nerve. This is well seen in a frog which has been decapitated. If a little sulphuric or acetic acid be applied to the inner portion of the thigh of a frog which has just been deprived of its head, it will immediately put up the other foot to remove the irritat¬ ing substance. If the acid is applied to the belly instead, both feet will be raised, and vigorous movements will be made to remove it. If placed upon its feet, such a frog will remain perfectly quiet if wholly undisturbed ; but so soon as any sort of irritation is applied, as tick¬ ling with a stick, pricking, or even jarring of the object on which it rests, it will leap forward as though alive. These movements are said to be reflex because they are supposed to originate in the manner described, from the gray matter of the cord. There are eminent phys¬ iologists who maintain that experiments of this kind prove that the cord as well as the brain is the seat of mind, even going so far as to assert that mind exists wherever gray matter is found, being a prop¬ erty of nerve-cells. The spinal cord also acts as a conductor of sensations to the brain, and of volitions from it. The nerves of general sensibility convey to the spinal cord impressions received in various parts of the body, when they are carried up to the brain by means of the gray matter of the cord. The brain then wills the performance of an act, and the force necessary to excite the muscles to contract is sent down the spinal cord and thence out through some of its nerve branches to the part from whence the impression came. For instance, if a pin is thrust into the finger, the sen- 136 ANATOMY, PHYSIOLOGY, AND HYGIENE. sation which we call pain is transmitted by means of a sensory nerve to the cord, which passes it up to the brain, where the sensation is really felt, the brain itself being not sensitive, since it may be cut and torn without pain, though it appreciates inj uries done to other parts of the body. The cord is thus seen to be both a conductor of nerve force and a nerve center or force generator. The reflex action of the cord is often seen in human beings in cases of paralysis in which there is loss of power to control the lower extrem¬ ities. We have frequently met with such patients, in whom the limbs could be made to twitch with considerable force by titillation of the soles of the feet, though the muscles would not act in obedience to the will on account of some inj ury in the nerve centers having charge of that part of the body or in the nervous communication between the two. Functions of the Spinal Nerves. — The thirty-one pahs of nerves which originate in the spinal cord are each double. This might be easily surmised from the fact already stated, that each nerve has two roots, one of which arises from the posterior portion of the cord, the other from the anterior portion. It has been found, by experiments upon annuals, that the fibres which come from these two roots differ from each other in function, the anterior roots being nerves of motion, and conveying nerve force from the cord to the muscles, and those which are connected with the posterior root conveying impressions from various portions of the body to the cord. Hence the anterior root and fibres arising from it are termed motor, the posterior root and its fibres being called sensory. A curious fact discovered by physiologists is that both the motor and sensory fibres, which, as we have seen, communicate with the brain through the cord, cross over to the opposite side from that on which they enter the cord before passing into the brain. The sensory fibres pass over or decussate soon after entering the cord, while the motor fila¬ ments cross over in the medulla oblongata, or at the base of the brain. The consequence of this is that if an injury happens to these nerve fibres in the brain or the cells in which they terminate or originate, the inj ury will be manifested upon the opposite side of the body. Thus, paralysis of one side of the body may be taken as evidence that the opposite side of the brain has been injured. Functions of the Cranial Nerves. — The functions of the nine cranial nerves are far less simple than those of the spinal nerves j ust de¬ scribed. In some instances a nerve has both motor and sensory func¬ tions, but in several others a nerve has but a single function. Several SYMPATHETIC SYSTEM— THE MIND. 137 of the cranial sensory nerves, instead of possessing general sensibility, have peculiar sensory properties, from which they are termed nerves of special sense. The optic, or nerve of sight, auditory, or nerve of hearing, the olfactory, or nerve of smell, and the gustatory, or nerve of taste, are those which possess special sensory properties, and these possess little or no general sensibility. The fifth nerve should be specially noticed as the great sensory nerve of the face, since it is disease of this nerve which is the occasion of so much suffering in tic douloureux, or facial neuralgia. A branch of this nerve supplies the teeth, and hence it is that decayed or diseased teeth are so frequent a cause of facial neuralgia. Functions of the Sympathetic System.— The name of this sys¬ tem of nerves very well indicates its general character. Besides having charge of the nutrition of the body, its vegetative or organic functions, it connects or associates together the different parts of the system, so that when one member suffers, the others suffer with it. A good illus¬ tration of the action of this system is seen in a simple experiment per¬ formed by Dr. Brown-Sequard. He observed that when he placed one foot in cold water, the other became warmer. In one instance the tem¬ perature of the foot not immersed rose seven degrees. The reason of this is that nature makes an effort to resist the effects of the cold ap¬ plied to one foot, by increasing the supply of heat ; and through the sympathy of the other foot, its heat is increased also. The very common phenomena of “taking cold,” and numerous other instances of sympathy of one part with another, are due to the action of the sympathetic nerves. The Mind. — Whatever may be the correct doctrine respecting the nature of the human soul, about which science can really say very little, it seems very clear from what has been proven respecting the nature of the brain and its processes, that mind ls nothing more nor less than brain action. It is everywhere granted that the brain is at least the organ of the mind. It is certainly relevant to inquire, then, Is not the relation between the mind-organ and the mind analogous to the relation known to exist between the organ of digestion and digestion ? Digestion is a process, thought is a process. Digestion is the result of the action of the digestive organs : there is abundant reason to believe that thought or mind is the result of brain action. This view need not interfere with any theological views concerning the nature of the soul, since it 138 ANATOMY, PHYSIOLOGY, AND HYGIENE. is evident that whatever the soul is, it is something more than mind ; it must be greater than mind, since mind is only a result, from what¬ ever standpoint we look at it. Whatever there may be behind which we do not understand, and there is doubtless a great deal, mind is still the same, but a result ; and it may as well be considered as the result of brain action as of the action of any other cause. If we deny this regarding man, we must do the same respecting the brute, since he also lias a mind, and is capable of thinking, willing, and reason¬ ing to a certain degree. Perhaps we cannot do better than to quote the following paragraph from one of the foremost thinkers of the age, and one of the most distinguished writers on this subject, Dr. Henry Mauds- ley, of London : — “ It must be distinctly laid down that mental action is as surely de¬ pendent on the nervous structure as the function of the liver confessedly is on the hepatic structure ; that is the fundamental principle upon which the fabric of a mental science must rest. The countless thousands of nerve cells which form so great a part of the delicate structure of the brain, are deemed to be the centers of its functional activity ; we know right well from experiment that the ganglionic nerve cells scat¬ tered through the tissues of organs, as, for example, through the walls of the intestines, or the structure of the heart, are centers of nerve force min¬ istering to their organic action ; and we may fairly infer that the gan¬ glionic cells of the brain which are not similarly amenable to observation and experiment, have a like function. Certainly they are not inexhaust¬ ible centers of self-generating force ; they give out no more than what they have in one way or another taken in ; they receive material from the blood which they assimilate, or make of the same kind with them¬ selves ; a correlative metamorphosis of force necessarily accompanying this upward transformation of matter, and the nerve cell thus becoming, so long as its equilibrium is preserved, a center of statical power of the highest vital quality. The maintenance of the equilibrium of nervous element is the condition of latent thought — it is mind statical ; the man¬ ifestation of thought implies the change or destruction of nervous ele¬ ment. The nerve cell of the brain, it might in fact be said, represents statical thought, while thought represents dynamical nerve cell, or, more properly speaking, the energy of nerve cell.” Almost any amount of testimony might be added on this point, but this will suffice. It is readily granted that there are some diffi¬ culties, even with this view of the nature of mind ; but it is claimed THE MECHANISM OF THOUGHT. 189 that the difficulties with this view are much less than with any other, and that they are not insurmountable. The view deserves attention, at least ; since if it be true, it is destined to overturn many of the old philosophies in psychology. Indeed, it may almost he said that the old philosophies are already abandoned by the majority of the clear¬ est thinkers, on account of the great numbers of difficulties which at¬ tended them. The Mechanism of Thought. — Explained in accordance with the scientific theory of mind, the mechanism of thought loses much of its complexity, as we may be able to see. According to this view, thought really originates in the external world. The eye, ear, organs of touch, smell, and taste, and other sense organs, receive impressions from the external world, each carrying to the brain the particular kind of im¬ pression which it is fitted to convey. The eye conveys impressions of light, the ear of sound, etc. These impressions are received through the medium of the nerves by certain groups of cells lying at the base of the brain which are designed for this purpose. One group receives impressions of light, and of all the sensations 'which can be received through the eye. It can receive these kinds of impressions, and no others. The same may be said with respect to each of the other senses. The special organs, or ganglia, which receive these impressions, transmit them through connecting branches to the intellectual part of the brain in the cerebrum, where they are recognized as light, sound, odor, etc., and this is thought. In this way, ideas respecting the size, form, color, and other properties of objects, are formed. If the gan¬ glia at the base of the brain convey to the cerebrum the impressions which they are in the habit of doing, without being excited to do so by the external agents upon which they are dependent, the result is the same. If action of the ganglia which presides over the organ of sight is excited and the cerebrum informed of the fact, the individual will receive the perception of light even if no light is really seen. Action of this sort may be excited in a variety of ways, as by me¬ chanical irritation or by the use of electricity. Every one who has received a severe blow upon the head, as by a fall upon the ice, is aware of the fact that concussion of the head will cause a person to see flashes of light. A story is told of a man who in an English court testified to having seen a man who assaulted him in the dark by the light produced by a blow on the head which he received from his as¬ sailant. It is not stated whether the testimony was received or not 140 ANATOMY , PHYSIOLOGY, AND HYGIENE. Of course it could not be true, since light thus produced is not real, having no existence except in the brain. We have many times pro¬ duced the same phenomena by the application of a current of elec¬ tricity to the head. Distinct flashes are seen, though the eyes are closed. From this it appears that the impression we call light is in the brain due to action of certain nerve cells. The same experiment may be made with all the other organs with a like result. Ordinarily, seeing is the reception of light-waves through the medium of the eye, which is an organ specially constructed to receive them, by which means the optic nerve is made to convey an impression of a certain sort to the cells in the brain set apart for the reception of such impres¬ sions, which are thereby induced to act, which action is recognized by the cerebrum, the seat of the intellect, as light. If the optic cells are made to act in any other way the result is the same, as we have seen. It is very evident, then, that so far as the external world is concerned, all knowledge respecting it comes to the brain through the organs of sense, the only avenues of communication between the brain and the outer world. A careful analysis of our stock of knowledge will show that it all relates to things of which we have gained information by means of our senses; that is, all our knowledge is made up of, or derived from, data collected for us by the eye, ear, touch, and other sense or¬ gans. If this is not clearly seen at once, it will be by the supposition of a case. Let us imagine a person born into the world without a single one of the seven senses. It is inconceivable that such a person could have a single thought. The life possessed would be but a vege¬ tative one. The brain would necessarily be an utter blank, since it would be without the most simple materials for thought ; there would be no means by which the intellectual machinery could be set in motion. We have not space to elaborate this subject further, and here leave it for the consideration of the reader, hoping that those who are pre¬ pared to appreciate the questions at issue will continue their investiga¬ tion of the nature of mind and the relation of mental activity to the brain and nerves. The Will. — That power of the mind by which the voluntary acts of the body are determined or controlled is termed the will. This is undoubtedly the highest function of the brain, since all other of both the bodily and mental functions are in some degree subject to it, either directly or indirectly. While this is probably the most obscure of all TIIE NATURE OF THE WILL. 141 the questions connected with the physiology of the brain, there are some very interesting facts known concerning it which are well worthy of consideration. First, as to the nature of the will. This has been the subject of lively discussion among physiologists and metaphysicians for centuries. We hear much about free will ; yet when we come to study the mani¬ festations of volition we find that they are far from possessing that degree of freedom which the generally accepted doctrines on the sub¬ ject would lead us to suppose. If we carefully analyze an act of vo¬ lition, we shall find that desire is the prompting impulse in most if not all cases. When we act, it is because something which we regard as valuable to ourselves or some other being is to be gained by so do¬ ing ; in other words, we act because it is desirable to do so, or seems to us to be desirable. We always do what at the moment seems to be best, whatever its ultimate consequences may be, and irrespective of our knowledge of the consequences. When we refrain from action, it is because we desire to do so. Thus will may be manifested in two ways, positively and negatively, in acting and in refraining from ac¬ tion ; but in both instances the prompting of will is desire. This fact seems so clear that we apprehend no one will dispute or disagree with it who will stop to reason candidly on the subject. If we examine into the nature and origin of desire, we shall find that it grows out of a complex combination of circumstances and influences; first of which may be mentioned, inheritance. Our mental and physical constitution is largely the result of the habits and education of our par¬ ents and ancestors for many generations back, together with special cir¬ cumstances governing our early development. As Dr. Oliver Wendell Holmes has very well said, “Each of us is only the footing up of a double column of figures that goes back to the first pair. Every unit tells, and some of them are plus, and some minus!’ The proofs of this are too numerous to need citation here. Again, our desires are in a great degree the result of our education. Our tastes change vuth changes in our circumstances. They are modi¬ fied by age, and by our associations and social surroundings. Our de¬ sires are influenced by those of our friends, by the books we read, by the food we eat, by the condition of our bodily health, and by a great vari¬ ety of circumstances. It is obvious, then, that as the will is excited to action by desire it is far from being wholly f ree, since it is indirectly so dependent on other influences and circumstances. 142 ANATOMY, PHYSIOLOGY, AND HYGIENE. We are well aware, also, that the will is greatly modified by disease. A person who in health is active, energetic, positive in all his move¬ ments, becomes while suffering from some indisposition, the very reverse. A fit of sickness, a pecuniary loss, or other misfortune, will not infre¬ quently change a person’s disposition and the character of his will man¬ ifestations, for life. A careful study of the relation of the will to the body will show that its domination is far less complete than usually supposed. It has no power over the functions of organic life, as of the heart and blood-vessels, the stomach, intestines, and other vital organs, and it is fortunate for us that it has not, as the uncertain action of the will — it being so readily affected by a great variety of causes — would be fatal to the healthful and harmonious action of the vital machinery. Even the power of con¬ trol of the so-called voluntary movements is only acquired by degrees and after a protracted effort. In this respect, man is inferior to some lower animals. The little child learns to walk by painful and laborious efforts. At first it cannot control the muscles necessary to effect locomo¬ tion. It can readily understand what movements must be made, long before it can acquire the power to make them. The beginner in piano- playing fully appreciates the difference between knowing how to do, and doing. The will calls upon certain muscles to act, but they will not un¬ til they have been trained to do so. This fact is further seen in the great difficulty of making separately movements which have by habit been associated, as for example, closing one eye while keeping the other open ; or moving one hand back and forth in a horizontal plane while the other is being moved in a vertical plane, both palms looking down¬ ward. It is, indeed, sometimes impossible for us to control our mental operation's by the will. We cannot think of what we wish to. We cannot on all occasions concentrate our minds upon the subjects of which we desire to think. The mind will wander into other fields; other and widely different subjects of thought will occupy its attention in spite of the most vigorous efforts of the will to the contrary. We cannot com¬ mand the brain to stop thinking. It will not obey if so commanded. We cannot even compel it to stop thinking upon any special subject which may be occupying it except by displacing it by some other idea, which may be in turn again displaced by the original thought before we are aware of it. Without further argument it must be evident that the will is by no means wholly free, but that it is, in a very large degree at least, the re- THE NATURE OF MEMORY. 143 suit of the operation upon us of the various external influences with which we are surrounded. Physiologists have never been able to locate the will in any partic¬ ular organ of the brain. It is probable that it exists in immediate con¬ nection with each of the various cerebral centers ; in other words, that each group of cells which receives nerve fibres from the outside of the body and sends back motor fibres possesses its own volition, the will being the sum total of action of all these volitionary centers. Memory. — Memory is that faculty or property of the brain by means of which we are enabled to accumulate knowledge. To say that all of the problems involved in a complete explanation of memory may be easily solved, would be claiming too much. This much seems pretty certain, however, viz., that memory is due to the fixing of impressions in the structure of the brain. This view harmonizes perfectly with all the known facts relating to this most valuable function of the mind. Every impression received, occasions an action of certain parts of the brain. As changes of substance are constantly taking place in the brain, it is but natural to suppose that cells which are acting will be modified in accord¬ ance with the particular manner in which they are acting, their struct¬ ure being thus modified by their action. If this were the case it would follow that the longer the action were continued the more intense would O be the impression made upon the structure of the cells acting, and the more lasting. This is exactly what does happen. The longer an object is viewed, the longer the memory of it remains. The things and places which are often seen and become very familiar to us are seldom forgot¬ ten. Again, if this theory is correct it would follow that the larger the number of cells brought into action by an impression as associated with it, the more intense and lasting would be the impression. This, too, is un¬ doubtedly true. We much better recollect things that we both see and hear, than those which we simply see or hear. Objects that we not only see and hear but are also able to touch, taste, smell, and otherwise inves¬ tigate, we retain in mind the most accurately and the longest. In fact, the great secret of a good memory is concentrated attention and associa¬ tion of many senses and faculties in observation. By this means we gain the advantage of the memory of several different organs or cell groups by which to recall the object or fact which we wish to remem¬ ber. This theory also explains the phenomena of habit. By frequent ac- 144 ANATOMY, PHYSIOLOGY, AND HYGIENE. tion in a certain way the structure of the nerve cells which command the action becomes so modified that they act more readily in that particular way than in any other. This fact, if it be true, and there seems hardly a chance to doubt it, is certainly very suggestive of the importance of cultivating right habits of thought, speech, and action, since the task of remodeling a deformed and distorted brain is an exceed¬ ingly difficult one. Blushing. — The sudden reddening of the cheeks known as blush¬ ing, is due to the influence of certain emotions upon the vaso-motor center, that is, the part of the brain which controls the blood-vessels of the body. In some persons, blushing is wholly confined to the cheeks, while in others it extends to the forehead, and in still others to the neck and shoulders. Through the influence of mental emotions the walls of the blood-vessels become relaxed, causing an unusual afflux of blood to the part, which imparts the characteristic redness. An experiment sometimes performed by physiologists upon white rabbits illustrates the phenomena of blushing and explains its mechanism. In the white rab¬ bit the skin is white, and so transparent that changes in the blood-vessels can be as readily noted as in human beings. Placing the animal under the influence of ether, the experimenter divides the nerve which controls the circulation in the ear. The result is that the ear immediately be¬ comes flushed ; in fact, it blushes. If the nerve is prevented from uniting, by removal of a portion of it, the flushing will continue, and, in consequence, in the course of a few months it will be found that the ear affected by the operation has grown to be appreciably larger than the other, in consequence of its larger supply of blood. Pain and its Uses. — Pain is simply a mollification of general sen¬ sibility. It arises from excessive irritation or stimulation of the nerves. Thus, the same irritation which in moderate degree, or when of short continuance, is agreeable, giving pleasure, when rendered more intense, or even if long continued, becomes exceedingly painful. For example, the sense of contact of bodies with the skin is not unpleasant, and is often very agreeable ; but when the contact is made in a peculiar man¬ ner, as in titillation, it may become painfully unpleasant. Light is pleasant and grateful to the eye in a moderate degree, but becomes very painful and unbearable when we attempt to look at the sun. Pain is useful as a warning of impending evil. It puts us on our guard by informing us that the tissues are in danger of being injured in some way. Although unpleasant to bear, and often an unwelcome vis- PAIN AND ITS USES. 145 itant, pain is a guardian, a faithful sentinel. If it were not for the warnings and admonitions we receive from this source, we would speedily subject the delicate organism to such violence as to impair its functions, if not entirely destroy its utility. This fact is well seen by the accidents to which persons are exposed who are in any way de¬ prived of this means of warning. For instance, a person who had through disease lost the sense of feeling in his lower extremities, in tak¬ ing a foot bath put his feet into water so hot that the feet were badly burned, being actually parboiled. A gentleman of our acquaintance who had lost the sense of feeling in one arm bv an accident in which the sensory nerves of the arm were divided, while at work on a cold day unconsciously froze the fingers of the affected hand so badly that death of the tissues took place and considerable portions were lost. Other similar instances might be cited. The warnings of pain should always be heeded. Nature makes no unnecessary complaints. While it is not wise for a person to be on the lookout for pains, magnifying every un¬ comfortable sensation, it is important that the timely admonitions of be¬ ginning disease should be carefully heeded. Neglect of this often sacri¬ fices useful lives which might easily be saved with timely attention. Pain, then, should be looked upon as a beneficent provision of nature rather than as an enemy. The great physiologist, Magendie, makes the following interesting remarks concerning the nature of pain : — “ Though it may appear like sophistry to say that pain is the shadow of pleasure, yet it is certain that those who have exhausted the ordi¬ nary sources of pleasure have recourse to causes of pain, and gratify them by their effects. Do we not see in all large cities that men who are debauched and depraved find agreeable sensations where others ex¬ perience only intolerable pain ? ” We have seen old topers whose sensibilities had become so depraved and benumbed that the strongest liquors failed to excite them, fill a wine¬ glass with peppersauee, and quaff the liquid fire as though it were a glass of milk or the mildest claret. Numerous experiments and observations show that the capacity for pain increases with the fineness of the organization. It is pretty clearly settled that lower animals suffer much less from the same injury than man. Indeed, it is maintained by some that in the lowest orders, as* in worms and reptiles, there is little if any sensibility to pain, the contor¬ tions arising from injury, being really reflex in character. It is notice- 10 14G anatomy, physiology, and hygiene. able that savages, as a rule, are less sensitive to pain than civilized persons. Sleep. — Sleep is a physiological condition in which there is cessation of activity of the upper lobes of the brain. When a person goes to sleep, the blood leaves the brain, the membranes becoming pale and the activity of the nerve cells ceasing in consequence. Upon waking, the blood returns again very quickly. This fact has been observed not only in animals, but in human beings in whom large portions of the skull have been removed by accident. During perfectly sound sleep there is no action of the thinking cells of the brain. There may or may not be some degree of activity of the central ganglia, the sensational centers, so-called, at the base of the brain, but there will be no degree of activity in the cerebrum. Dreams never occur in perfectly sound sleep. They are an indica¬ tion that there is not complete cessation of activity in the cerebrum. The will being dormant, the various faculties act in an irregular, dis¬ orderly manner, giving rise to a great variety of absurd, grotesque, in¬ consistent mental pictures. It has been remarked that dreams are the best index to a person’s character, since they are really but the echoes of our waking thoughts. The superstitious confidence which many persons put in dreams is in the highest degree unphilosophical, and has not a shadow of evidence in its favor. Late eating and deficient phys¬ ical exercise are the most common causes of bad dreams. Somnambulism. — The habit of walking about while asleep is one of the most curious of all the phenomena of nervous action. The som¬ nambulistic state is simply an exaggeration of the state of dream. It is a condition in which the intellectual faculties are dormant, while many parts of the brain seem to be even more active than usual. While in this curious state, persons will accomplish feats which would be impos¬ sible for them while awake. Many remarkable instances of somnambulism are recorded. For example, a story is told of one Cortelli, who “ was found one night asleep in the act of translating from a dictionary. When his candle was extinguished, he arose and went to seek another light. When any one conversed with him on any subject on which his mind was bent at the time, he gave rational answers, but he seemed to hear nothing that was said to him or near him on other subjects. His eyes also seemed to be only sensible to those objects about which he was immediately engaged, and were quite fixed ; so much so, that in read¬ ing he turned the whole head from side to side instead of the eyes.” MESMERISM. 147 Another very remarkable case is related by the Archbishop of Bordeaux in the “ Encyclopedia Methodique.” “ It was concerning a young priest at the Catholic seminary, who used to rise in his sleep and write sermons. Having written a page, he would read it aloud and make corrections. ‘ I have seen,’ says the Archbishop, ‘ the be¬ ginning of one of his sermons which he had written when asleep ; it was well composed.’ . He continued to write, although a card was held between his eyes and the paper. Did the history stop here, we should have a well-authenticated case of vision without the aid of the eyes. But the collateral circumstances show that this writ¬ ing was accomplished, not by sight, but by a most accurate mental representation of the object to be attained. For after lie had written a page requiring correction, a piece of blank paper of the exact size was substituted for his own manuscript, and on that he made the cor¬ rections in the precise situation which they would have occupied on the original page. A very astonishing part of this report is that which relates to his writing music in this sleeping state, which it is said he did with perfect precision. He asked for certain things, and saw and heard such things, but only such things, as bore directly upon the sub¬ ject of his thoughts.” There seems to be a very close relation between the somnambulistic and the mesmeric states. In both there is voluntary action, though the will does not seem to be fully dominant, since movements appear to be in a considerable degree automatic. Mesmerism. — The secret of mesmerism appears to be in getting the will of the subject inactive, and then putting his sensational centers in operation through the medium of the senses. We cannot imagine that a person could be mesmerized who could neither hear, see, nor feel. From a somewhat careful study of the nature and phe¬ nomena of mesmerism we are convinced that at least the greater share of the manifestations, if not the whole, can be explained in this way. At least, we have never seen manifestations which could not be thus explained, without the supposition of any occult force. When a per¬ son is to be mesmerized, he is placed under conditions the best calcu¬ lated to make the will dormant. There must be silence. The subject is usually told to direct his eyes upward, either looking at his hand or at some small, indifferent object which presents few details to furnish fund for thought. After a certain length of time, longer or shorter, according to the individual, in some persons the mind will become va- 148 ANATOMY, PHYSIOLOGY, AND HYGIENE. cant of thought, the will inactive. The mental organs are then in a condition exactly analogous to that of a scale beam evenly balanced. It is ready to act just according as the impression shall be made, and so nicely adjusted is the balance that only a very slight impression is necessary to turn the scale. The operator then closes the eyes of the sub¬ ject or tells him to do so, perhaps placing his fingers upon his eyes for a moment. Then he will say to him in a very positive manner, “ \ ou cannot open your eyes.” The operator does not ask the subject if he can open his eyes, but assures him that he cannot. If he finds that the eyes are not opened, he then feels quite sure that his subject is in a condition to be influenced. Then when he tells him to open his eyes, they are opened. He wishes him to appear to be engaged in fishing. He puts into his hands something slightly resembling a fishing-rod, it may be a ruler or a cane. Then he puts into his mind the desired idea by telling him that the object he holds is a fishing-rod. He offers him something and calls it a line, pretends to find the hook and to put a worm upon it, then points in an appropriate direction and says, “ There are the fish, see them ! throw in your line and catch one.” Thus the mind of the subject is influenced by what is said and done to him, what he sees, hears, feels, and otherwise appreciates through his senses. All persons cannot be influenced in this way, simply be¬ cause their positive mental organization will not allow the mind to become vacant and the will dormant. Persons who are easily mes¬ merized are those who are naturally easily influenced, whose imagina¬ tions are easily excited. A condition very similar to the mesmeric state can be induced in animals as well as in human beings. The most popular and successful mesmerist at present exhibiting in this country said to us a few months since in a conversation on the subject of mesmerism, in answer to the question whether the sub¬ ject was not affected wholly through the medium of the senses, “Yes, chiefly so.” He endeavored to maintain that there was some degree of direct action of mind upon mind, but was utterly unable to pro¬ duce an instance in which this was done, even when full credit was given to his own testimony. There is evidence for believing that the cases which seem to illustrate this power of mind are cases of fraud. Animal Magnetism. — So much has been said upon this subject of late years that we cannot refrain from offering a word upon it, es¬ pecially as there exist such wide-spread errors concerning it. The doctrine of an occult force by which one person may operate ANIMAL MAGNETISM. 149 upon another, or by which one mind may affect another otherwise than through the medium of the senses, seems to have originated in Paris, in the latter part of the last century, with a pretender whose claims were investigated by a committee appointed for the purpose by the French Academy. Benjamin Franklin, who then resided in Paris, was a member of the committee. After a careful and thorough ex- animation of the claims of the pretender, they were pronounced to be utterly unfounded, it being decided that the phenomena apparently due to the operation of some unseen force, were wholly attributable to the imagination of the subjects rather than to magnetic or any other form of force communicated by the operator. We firmly believe that this simple explanation was the correct one then, and is correct still. We have never yet seen nor heard of any phenomena of the sort in question which were not fairly attributable either to the imagination or to some tangible cause which could be easily pointed out. A few years ago while studying the medical uses of electricity with one of the most eminent physicians of New York City, who was at that time in charge of the department of nervous dis¬ eases at the great Demilt Dispensatory of that city, we had abundant opportunity of testing the matter, and were fully satisfied with the results. The physician referred to was at that time engaged in a series of experiments in what he termed mental therapeutics. Under the guise of animal magnetism he was experimenting upon the imagination of the patients who came under his care. Not a particle of medicine was used, nor any other remedial agent. The patient was simply made to believe that he was being treated by means of a powerful magnetic current ; yet, as the Doctor frequently remarked, tlce results were as good as under any method of treatment he had ever employed. The same method was not adopted in all cases, but was varied according to individual peculiarities, the same general principles being followed, however, throughout the course of experiments. In some instances the patient was allowed to think that the magnetic virtue had been imparted to a certain very bad tasting but inert liquid of which he was, with much solemnity, directed to take exactly one drop once in twenty-four hours, just as the clock was striking twelve, and on no account to take a larger quantity, or to take it at any other time, as the consequences might be something terrible. The effect of infinites¬ imal doses was under these circumstances decided enough to gratify 150 ANATOMY, PHYSIOLOGY, AND HYGIENE. the most enthusiastic advocate of high potencies. A solution of noth¬ ing in reality but a bad taste, potentized by the imagination of the patient, wrought wonders of which the most successful “magnetic healer ” would be proud to boast. Yet there was no chance for the operation of any other force than the minds of the patients themselves. To the influence of the mind upon the body must be attributed all the so-called magnetic cures. A careful study of the nervous system and of the nature of nerve force makes it very apparent that the only way in which one mind can operate upon another is through the senses. From all we know of the mind, its only avenues of knowledge are the seven senses. These may receive impressions from external objects and transmit them to the brain; but there is no other means known by which knowledge of any sort can be imparted. The idea that nerve force can be communicated through any other medium than nerves is not to be entertained for a moment by scientific physiology. The simplest experiments demonstrate the fact that nerve force, volition, mind im¬ pulses, or whatever the force may be called, can travel on nothing but nerves. For instance, suppose the nerves which control the hand be divided. The most powerful effort of the will possible is now utterly powerless to cause the hand to move or to show any sign of obedience to the mind. The ends of the divided nerve may be united by mus¬ cular fibre or other living tissue, but still the channel over which nerve force is wont to travel with such -rapidity is wholly interrupted. The best conductors of electricity, a force more closely allied to nerve or mind force than any other, may be used to splice the divided ends, but still the result is the same. The divided nerve ends may be pressed together as closely as mechanical contact can be made, and yet there will be no transmission of force beyond the point of division. Before the connection between the brain and the hand can be restored, the ends of the nerve must grow together, there must be a restoration of the continuity of structure which was broken down in the severing of the nerves. When this is done, the nerve resumes its function. The nerve force travels over it with the same facility as before, and the hand is again under the domination of the will. The deduction is a very clear one that if the mind cannot control or in any way in¬ fluence an organ which is actually a part of the body, through which the same blood flows which circulates in the brain, and the muscular and membranous and bony tissues of which are one with the rest of ANIMAL MA GNETISM. 1 51 the body, the only difference being the division of some of the nerves or force conductors, — if under these circumstances the mind or will is powerless to opei'ate, then how can it be possible that it should have power to aflect by mere volition objects which are remote from it, or even objects which may be touched by the outer surface of the body ? There can be but one answer to this question. The brain can only operate through the medium of nerves. But we shall be asked to answer several questions. Perhaps the most frequent query will be, “ If this view be correct, how do you ac¬ count for the magnetic influence which some persons seem to possess by which they can influence an audience so wonderfully, swaying their feelings at will ? ” We answer, there is no evidence that any person possesses such magnetic power. Individuals often possess wonderful powers of influence, and people differ much in this respect. One man will hold a large audience spell-bound for hours, while another can scarcely keep a half-dozen in their seats until he has finished. The difference consists, not in the possession of magnetism by one and its want by the other, but in the different manner in which the two per¬ sons address their hearers. Let the most powerfully “magnetic” speaker stand before an audience of persons who are both blind and deaf, and how much influence could he have over them ? Not a whit. He might exert himself to his utmost, he might imagine himself a powerful generator of magnetism, and suppose himself to be throwing out oceans of magnetic force, but the result would be wholly negative. If a force of the kind supposed really existed, the persons situated under the circumstances described would feel its influence as really and as intensely as though they could both see and hear. This simple experiment would settle conclusively the question of magnetism in public speakers, and would make evident the fact that what is termed magnetism in these cases is simply the sum total of the qualities which go to make up a good speaker, especially the gestures, the ex¬ pressions of the face and attitudes of the body, the quality and inflec¬ tions of the voice, the personal appearance of the speaker, and like qualities, all of which appear to the senses and depend for their influ¬ ence wholly upon the impressions thus made. “Magnetic rubbers” effect their cures in two ways : by means of exciting the imagination of the patient, and by means of the vigorous rubbing to which they frequently subject their patients. It is partic¬ ularly noticeable that this class of quacks never cure any organic dis- 152 ANATOMY , PHYSIOLOGY , AiV£> HYGIENE. ease. In many instances the maladies which they seem to expel as by magic are imaginary ills which do not really exist at all, except in the mind of the patient, or trivial functional disorders which are readily controlled by the mind when the patient is made to believe himself well. As a means of curing diseases through mental influence, the myth, “ animal magnetism,” is unrivaled, and as such it has done a great amount of good ; but on the other hand the belief in this fallacy has done a vast deal of harm by diverting the minds of the credulous away from the true principles of hygiene and the healing art. Hence we believe that it ought to be thoroughly exposed and condemned. Whatever good there may be in appealing to the imagination as a means of cure can be utilized without resorting to any such quackery as is universally connected with the practice of “ magnetic doctors.” Mind-Reading. — The recently developed phenomena of mind¬ reading, so called, have been taken by many as positive evidence of the existence of some hidden means by which one mind may communicate with another otherwise than through the medium of the senses. We have been much interested in the phenomena exhibited by persons professing to have this power, and have taken some pains to investigate them; We enjoyed the opportunity of being present, by invitation, at a meeting of scientists, clergymen, physicians, and lawyers, held for the purpose of testing the claims of the first mind-reader who ap¬ peared before the public, a few years since. The operation called mind-reading consisted in the operator’s taking the hand of the person whose mind was to be read and pressing it firmly against his forehead, after having been securely blindfolded, and then leading him to some place in which the individual had previously secreted some object without the knowledge of the operator. In nearly every case this was done successfully, no matter how distant the spot nor how cir¬ cuitous the route taken in secreting it. The operator claimed to put his mind in communication with that of the person with whom he was operating, and to learn by this means the location of the object. The result of the investigation was to show very clearly that the pre¬ tended mind-reader could not read the mind of any one but himself, and that he had no means of getting information except through the senses; but that he possessed an uncommonly fine sense of touch by which he could appreciate very slight, and to the individual operated with, involuntary, muscular movements. It was always necessary that the subject should keep* his mind intently occupied with the object PHRENOLOGY. 153 during the whole experiment, otherwise it was never successful. This would naturally incline the individual to make the slightest resist¬ ance when moving in the direction of the object. This is undoubtedly the correct explanation of the mind-reading mystery. Dr. Geo. M. ^emeration { tOEALTY / SUBHU ITY q OEST R\jCTi lANJUAOE Fig. 76. A diagram showing the position of the various mental organs or “bumps” as located by phrenology. Beard, of New York, and other eminent scientists, have carefully in¬ vestigated the same phenomena, and have arrived at essentially the conclusions stated. Phrenology. — Probably no psychological theory originated in modern times has had so great an influence upon the minds of the civilized people of the globe as has the theory originated by Gall and Spurzheim, known as phrenology. Taken together with physiog- 154 ANATOMY, PHYSIOLOGY, AND HYGIENE. nomy, this theory attempts to determine a man’s character by the ex¬ ternal configuration of his skull and face. With the exception of a very few points which may be considered as quite well established by physiological and pathological observations, the theory must be considered as strictly empirical in character. As such, it must be sub¬ ject to great changes. Since it cannot be said to have an anatomical basis, as all settled theories relating to the brain and nervous system must have, phrenology is certainly liable to great and very considera¬ ble changes, as the structure and functions of the brain are more thoroughly worked out by scientific research. While there is much that is good in phrenology as taught by its ablest exponents, it is capable of being made an agent for great in¬ jury; and we have sometimes questioned whether almost as much harm as good was not done by it as it is generally used. Attracted by its novelty, thousands have studied it sufficiently to get a very slight smattering of the names and locations of the “bumps,” and then, supposing they possessed all the requisites to make them com¬ petent to delineate the characters of their fellows, point out deficien¬ cies and merits, etc., they have set themselves up as phrenologists, head-examiners, bump-feelers, — blunderers would be a much more proper term to attach to them, — when in fact they hardly possessed intelligence and mother-wit enough to become first-class barbers. The amount of trash which has been retailed about the country, es¬ pecially in the rural districts, under the name of phrenology, is ap¬ palling. The harm that these charlatans do is incalculable. They fumble the heads of those who visit them, assume a wonderfully wise look, and then proceed to deal out to them a character according as their fancy dictates, or as will the best serve their purpose. Even when a man has sufficient information and experience to enable him to form a nearly correct estimate of a person’s character, he may still be utterly unqualified to give the proper advice to individuals re¬ specting the best course to pursue to remedy their defects. The busi¬ ness of giving advice to people concerning the work of reforming de¬ praved characters, or correcting natural deformities of mind, mental and moral, is certainly second to no other in which a human being could be engaged, and ought to be attempted only by one who is in the most eminent degree qualified for the work. The problems which come before a physician who deals with the sick and disor¬ dered body are the simplest possible compared with those which pre- PHRENOLOGY. 155 sent themselves for solution to those who profess to be the physicians of the mind. Bad advice given by such an individual may do an in¬ calculable amount of harm, as we have had occasion to observe in more than one instance. We have known cases in which persons who had lived happily for some time in the relation of husband and wife have suddenly discovered that they were wholly uncongenial and incapable of being happy together after going to a phrenologist and being told that they were not adapted to each other. Not long since a young man rushed into our office in most precipitate haste, having hurried much as he knew we were about leaving to make a professional visit. He carried on his face a look of the most profound anxiety. There was evidently a real trouble on his mind. As we were about going out he begged us to stop just one moment. We in¬ quired if he was sick. “Oh, no,” he said, “but I must see you just one moment.” “ Is some one else suddenly taken ill ?” we asked, really feeling some little alarm, as he appeared so solemn and anxious. “No one is sick, he replied, “ but I want to see you a moment to find out what I am good for.” We were puzzled and*asked for an expla¬ nation, which he promptly made by saying that he had just made a visit to a phrenologist who informed him that he had made a mistake in choosing the life-work for which he was fitting himself, the gospel ministry, and that he should prepare himself for a physician instead. The young man was much agitated in reflecting that so much time had been lost, and wanted to begin at once in his proper sphere if he could do so. We quieted his fears when we learned the cause, advised him to pay no attention to the counsels of his unwise adviser, and to pursue the even tenor of his way as before. He was manifestly un¬ fitted for the work of a physician, though he had a great love for books, delighted in the study of language, was highly conscientious, and very desirous of doing good to his fellow-men. His lack of power to adapt himself to circumstances, and especially his want of ingenu¬ ity either mechanical or otherwise, clearly indicated that almost any other calling would be better fitted to him than that suggested by his adviser, who charged him a half-dollar for counsel which would have made his life a failure had he followed it. Upon inquiry we learned that the self-styled phrenologist had condemned his plan to fit himself for the ministry on account of his not possessing the phrenological sign of large language, although in fact he had a most excellent memory of words, having already acquired good command of three modern lan- 156 ANATOMY, PHYSIOLOGY, AND HYGIENE. images. The work of such men is damaging to the world, and far more so than they have any idea themselves. We believe that phrenology in the hands of those who make it a specialty has been carried to an extreme ; that claims are made by its advocates of powers which they do not and cannot possess. It is this, in fact, which has made the art, — it can hardly be called a science as yet, — obnoxious in the eyes of the great mass of scientists. Seeing that some claims are preposterous, they have neglected to investigate or give credit to any part of what is claimed. The many investigators who are now at work upon the cerebrum, examining its structure with the closest scrutiny of the microscope, and its functions by means of experiments upon living animals the nearest like man in their anatom¬ ical structure, will undoubtedly develop in time some facts bearing on this subject which will place what is true of the present phreno¬ logical doctrines upon a strictly scientific basis, and will add to them such elements as they lack of the completeness and definiteness which is required for a thoroughly symmetrical system of psychological science. • HYGIENE OF THE BRAIN AND NERVES. As the brain and nerves are the controlling parts of the system, it is evident that upon the preservation of their health must depend in a very great measure the health of the whole body. A man whose brain and nerves are diseased cannot be healthy otherwise; neither is a person whose nervous system is in a healthy condition likely to be diseased oth¬ erwise. The marked increase in nervous affections of late years has be¬ come so noticeable that almost every medical writer calls attention to it, and this fact makes especially important the consideration of the laws which relate to the healthy action of this part of the body. The nerv¬ ous structures are the most delicate of all the elements of the body; and when we consider the additional fact that they are subjected to more constant use than any other set of tissues, it certainly is not surprising that they should be specially subject to disease; but the great depend¬ ence of all other parts of the body upon the nerves makes it still more important that their integrity should be preserved. Necessity for Mental Exercise— Nerves as well as muscles re¬ quire exercise to promote their growth and insure their development. That both brain and nerves are capable of development by exercise, and that development of these structures is largely dependent upon proper NECESSITY FOR MENTAL EXERCISE. 157 exercise, are facts too well established to require proof by systematic evi¬ dence in this connection. Every-day experience convinces us of the fact. In the sharp contests of mind with mind in the battle for existence and the strife for fame, riches, and worldly honors, the mind which has been the most carefully trained to efficient action, which has by mental gym¬ nastics learned to exercise to advantage its powers, always comes off vic¬ torious. It is not essential that the training should have been given in a school, or that the mental exercise should have been practiced in an academy or a college ; the farm, the workshop, the forest, or the coal-pit may have been the training-school or the gymnasium, but the work was done, and in such a manner as to secure a satisfactory result, and that is all that need be asked. Mental exercise lies at the foundation of mental growth and mental health, and indirectly, we believe, it furnishes a firmer basis for mus¬ cular and general physical health than can be attained without it. The commonly received notion that mental work is harmful and incom¬ patible with physical health we believe to be a gross and pernicious error. Our college students, male and female, who break down in health just as they have finished their studies, or before they have completed their course, are not victims to mental overwork, as a general thing. The same may be said of the great army of valetudinarian clergymen, law¬ yers, merchants, and others whose occupations are sedentary while in¬ volving considerable brain-work. In the great majority of instances, the failure of health in these cases is the result of flagrant violations of the commonest laws of health, such as deficient muscular exercise, bad food, late hours, fashionable dissipation, and, most of all, mental worry. The student hives himself up in his close study, probably smokes from three to a dozen cigars a day, lives upon the poorest boarding-house fare, and takes only just such little muscular exercise as he is compelled to do in going to and from his classes. Soon he finds his head dull, and he begins to worry because he is troubled to master his lessons. Now instead of gaining mental strength by his daily exercise, he is each day wearing out the vitality and wasting the very substance of his poorly nourished brain. Mental worry is corroding his intellectual powers, and he will sooner or later break down, a chronic invalid, and mental work will get the credit. In a similar way the clergyman, the lawyer, the politician, the merchant, breaks himself down. Thousands suffer with what is called “softening of the brain,” when that organ is wholly in¬ tact except so far as it suffers through sympathy with other diseased organs, the whole trouble being in the stomach and liver. 158 ANATOMY, PHYSIOLOGY, AND IIYGIENL. This subject is so generally misunderstood that we deem it worth while to devote considerable space to it, and hence we will call attention to a few facts in support of these views, which we have for several years advocated in various ways, chiefly in lectures and through the journal of which we have had the editorial charge. 1. There is nothing in mental work which should make it especially liable to break down the constitution. On the other hand, it is well calculated to insure the highest degree of health. Since all the force manifested in the body originates in the nerve centers, chiefly in the brain, it is evident that the more vigorous the brain, the more vigorous the manifestations of force in the organs dependent upon it. And this is^just the condition produced by mental labor. The brain grows in strength and vigor under exercise, and hence becomes capable of send¬ ing out more vigorous impulses to the various parts of the body depend¬ ent upon it for supplies of force. Mental exercise is also agreeable to those who devote themselves to it. Authors, philosophers, poets, lawyers, enjoy their work, if successful in it ; and only those who are successful, at least in a moderate degree, continue these pursuits. The same cannot be said of the mere mechanic or artisan who toils almost as mechanically as the machines which he employs. The poet loves his work and is loth to leave it. The hod- carrier gladly drops his hod and rejoices that his daily task is ended when the work bell announces the time at which he is allowed to stop. The muscle laborer seldom works unless necessity demands it ; while the brain- worker keeps on toiling as arduously as ever long after the accu¬ mulation of a competency makes his labor wholly unnecessary. We speak now, of course, of pleasant mental pursuits which are not dis¬ turbed by mental worry. The harrowing anxiety of the stock -broker or the gambler is not conducive to health, mental or physical. 2. Brain-workers are long-lived. This statement will be almost certain to be disputed, and so we must fortify it with incontrovertible facts, which, fortunately, we are well able to do. Quite a little re¬ search has been made upon this question within the last few years, and with most decided results in favor of mental workers. According to an eminent French writer, Gorgias the rhetorician lived to the age of one hundred and eight years, “ without discontinuing his studies and without any infirmity.” Epimenides, one of the seven “ wise men,” lived to the great age of one hundred and fifty-four. Hip¬ pocrates, the father of medical literature, who was a diligent student NECESSITY FOR MENTAL EXERCISE. 159 and wrote voluminous works, many of which are still extant though V o penned more than twenty centuries ago, lived to the ago of ninety-nine ; and his master, Herodicus, attained the age of one hundred. Galen, one of the most celebrated physicians of antiquity, wrote three hundred volumes, many of which are consulted as authorities at the present day, and lived to be nearly a hundred years of age. Cornaro lived to the age of one hundred, though of a frail constitution, and did vigorous mental work for seven or eight hours a day until his death. The great Stoic, Zeno, a diligent student, lived to the great age of ninety-eight, when he put an end to his life while in the full possession of his facul¬ ties because he had received what he took to be an admonition that his time to die had come. Socrates was murdered at seventy-one in the prime of life. Pythagoras, Pindar, Quintilian, Chrysippus, and Thu¬ cydides lived to the age of eighty or upwards. Polybius and Plato died at eighty -one. Xenophon, Diogenes, and Carneades died at ninety. Eu¬ ripides lived to the age of eighty-five. Anaxagoras died at seventy -two, and Aristotle at sixty-three. All of these men were hard-working stu¬ dents of nature and philosophy. They were the representative men of their times. They did work which has resisted the ravages of time and come down to us through the Dark Ages, in many respects work which cannot be surpassed in excellence, and often is unapproachable in its per¬ fection. Yet all of them lived to almost double the present average length of life. Their average length of life is more than ninetv-one years, which certainly does not militate against mental work as con¬ ducive to longevity. Dr. Madden, in an able work on the “ Infirmities of Genius ” gives twelve tables of noted men of twenty names each, which sum up as fol¬ lows : — AVERAGE AGE. Twenty Natural Philosophers, . . . . . .75 (( Moral Philosophers, ...... 70 cc Sculptors and Painters, ...... 70 cc Authors on Law, etc. , ..... G9 cc Medical Authors, ....... 68 cc Authors on Religion, ...... 67 CC Writers on Language, ...... 66 CC Musical Composers, . 64 cc Miscellaneous Authors, ...... 62 cc Dramatists, ....... 62 cc Writers on Natural Religion, ..... 62 CC Poets, 57 Average of these Two Hundred and Forty Brain- Workers, . 66 160 ANATOMY, PHYSIOLOGY, AND HYGIENE. That the unusual longevity of the brain-workers already referred to was not due to the fact that they lived at an earlier age of the world is evidenced by the fact that the same characteristic is noticeable among mental workers of the present day, as is shown by the following table, which is made up of men who have lived in recent times : — Bacon, Boger, 78 Young, 84 Buffon, 81 Ferguson, 92 Galileo, 78 Kant, 80 Copernicus, 70 Reid, 86 Lowenlioeck, 91 Goethe, 82 Newton, 84 Crebillon, 89 Whiston, 95 Goldoni, 85 Erasmus, 69 Watt, James, 83 Bentham, 85 Hobbes, 91 Mansfield, 88 Locke, 72 Le Sage, 80 Stewart, D. , 75 Wesley, John, 88 Yoltaire, 84 Hoffman, 83 Cumberland, 80 Pinel, 84 Southern, Thomas, 86 Claude, 82 Coke, Lord, 85 Titian, 96 Wilmot, 83 Franklin, 85 Rabelais, 70 Halley, 86 Harvey, 81 Rollin, 80 Heberden, 92 Waller, 82 Michael Angelo, 96 Chalmers, 83 Handel, 75 South, Dr., 83 Hayden, HI7 i ( Johnson, Dr., 75 Ruysch, 93 Cherubini, 82 Winslow, 91 Herschel, 84 Morgagui, 89 Laplace, 77 Cardan, 76 Linnceus, 72 Fleury, Cardinal, 90 Metastasio, 84 Auguetel, 84 Milton, 66 Swift, 78 Bacon, Lord, 65 Watts, Dr., 74 The average age of all the above-named persons, sixty in all, is a lit¬ tle more than eighty -two. It is very evident that experience is decidedly against the commonly received notions on this subject. Though further evidence n scarcely needed, we may add the following from a recently published paper by Dr. Geo. M. Beard, of New York, well known as an eminent electrician and neurologist : — O PROPER DEVELOPMENT OF CHILDREN’S MINDS. 161 “ I have ascertained the longevity of five hundred of the greatest men in history. The list I prepared includes a large proportion of the most eminent names in all the departments of thought and activity. “ It would be difficult to find more than two or three hundred illus¬ trious poets, philosophers, authors, scientists, lawyers, statesmen, gen¬ erals, physicians, inventors, musicians, actors, orators, or philanthropists of world- wide and immortal fame, and whose lives are known in suf¬ ficient detail, that are not represented in this list. My list was prepared, not for the average longevity, but in order to determine at what time of life men do their best work. It was, therefore, prepared with abso¬ lute impartiality ; and includes, of course, those who, like Byron, Ra¬ phael, Pascal, Mozart, Keats, etc., died comparatively 3-oung. Now the average age of those I have mentioned, I found to be 61.20. “ The average age at death at the present time, of all classes of those who live over twenty years, is about fifty. Therefore the greatest men of the world have lived longer, on the average, than men of ordinary ability in the different occupations, by fourteen years ; six years longer than physicians and lawyers ; nineteen or twenty years longer than mechanics and day-laborers ; from two to three years longer than farmers ; and a fraction of a year longer than clergymen, who are the longest-lived in our modern society.” Dr. Beard states among other conclusions at which he has arrived as the result of his investigations, — “ 1 . That the brain- working classes — clergymen, lawyers, physicians, merchants, scientists, and men of letters — live very much longer than the muscle- working class. “'‘2. That those who follow occupations that call both muscle and brain into exercise, are longer-lived than those who live in occupations that are purely manual. “ 3. That the greatest and hardest brain- workers of history have lived longer on the average than brain- workers of ordinary ability and industry. “ 4. That clergymen are longer-lived than any other great class of brain-workers.” Proper Mode of Developing the Minds of Children. — That there is a right way and a wrong way of dealing with young minds in order to develop them so as to fit them for their highest usefulness in after-years, is patent not only from the nature of things, but from the unsuccessful results to be seen in the illy developed minds of thousands 11 102 ANATOMY, PHYSIOLOGY, AND HYGIENE. of men and women whom we daily see trying in vain to make their way well in the world against the numerous obstacles placed in their pathway, the most insurmountable of which are the results of bad training. O In a great many instances, perhaps in the greater share of cases, the process of education is a process of perversion from first to last. The child, when put to school at an age altogether too early, instead of being led along the path marked out by Nature for him to walk in, in his pursuit of knowledge, is set to work, or gone to work at, in a manner the most remotely removed from the natural order. Instead of beginning where Nature does, with the development and training of the perceptives, the sources of knowledge, thus teach¬ ing the learner at the outset how to observe thoroughly and accu¬ rately, in nine cases out of ten the teacher begins by giving the child instruction which can have no other influence than to lessen his reli¬ ance upon his own powers of observation and perception, and lead him to take such information as is dealt out to him unquestioningly, and without being able to see any natural relations between the knowledge imparted and that which it is supposed to represent. Thus his edu¬ cation continues, Jjis mind being dwarfed by improper methods, and his body injured by unnecessary and harmful confinement, until the child either dies, becomes an educated dolt, or perchance, from natural brilliance of intellect, breaks away from the fetters forged around him and begins to think for himself at last, and then really begins to learn. The majority of children do not enjoy school-life. It is irksome to them. It is actually repulsive, and naturally so. Learning is made hard work, when for them it ought to be made play. Children do not generally like work, but they do love play ; and if instruction could be imparted to them through methods which would be to them play, a great gain would be made. The efforts of the managers of Kindergartens in this direction are certainly commendable, and we hope they will be successfully introduced into every city and village in the land. We heartily concur in the following observations on this subject made by Hr. Iiichardson, one of the most eminent medical sci¬ entists of Europe : — • “ For children under seven years of age the whole of the teaching that should be naturally conveyed should be through play, if the body is to be trained up healthily as the bearer of the mind. And it is wonderful what an amount of learning can by this method be at- SCHOOL CRAMMING. 1G3 tamed. Letters of languages can be taught; conversations in differ- ent languages can be carried on; forms of animal life can be classified; the surface of the earth can be made clear; history can be told as story; and a number of other and most useful truths can be instilled without ever forcing the child to touch a book or read a formal lesson.” School Cramming. — Nothing could be more unscientific nor more unphysiological than the popular methods of instruction in vogue in most of our schools for youth as well as in those for small children. The idea of education entertained by the average teacher is that it consists in infusing into the mind of the pupil the largest possible amount of knowledge which it can be made to contain. Little is thought of the necessity for thorough and systematic discipline of the mental faculties. Consequently, it is generally the case that the stu¬ dent’s entire experience at school or college is one continual course of perversion. Instead of being taught how to think and study to the best advantage, how to investigate for himself, how to originate ideas and to become mentally independent, the student is continually dis¬ couraged by the methods employed by his instructors, from any at¬ tempt at originality or independence of thought, and thus becomes a dogmatic mental dwarf. AYe sincerely hope that the day will come when our educators will regard the primary object of schools to be culture and training of the human body, mentally, morally, and physically. No system of education can be complete which does not give due prominence to the pupil’s culture morally and physically, as well as mentally. The acquisition of knowledge should be regarded not as the primary object of education, but as a useful incidental result, ne¬ cessitated by the nature of the discipline to be acquired. Students should be thoroughly imbued with the idea that the ob¬ ject of their school-work is not so much to impart to them a knowl¬ edge of facts, as to teach them how to acquire facts, how to investi¬ gate, how to compare, how to reason, how to utilize knowledge after it has been acquired. The methods of education generally followed in our colleges, fill young men with facts, and pack their craniuins with the ideas of men who lived two thousand years ago, and then Graduate them and send them out into the world destitute of even a modicum of practical knowledge, without the ability to use the facts which they have gained. Such men have much knowledge, but are unable to use it to practical advantage; and a score of them are of 164 ANATOMY, PHYSIOLOGY, AND HYGIENE. less real use to the world than one practical man whose fund of in¬ formation is almost infinitely smaller, but who possesses the faculty of utilizing knowledge. There is great need of reform in our educa¬ tional institutions, and we are glad to see some evidences of improve¬ ment in this direction. The times call for practical men, and the pub¬ lic mind is being aroused to ascertain why there is so great a scarcity of men of this class. We hope the inquiry will continue, and that the agitation of the question which has begun, will increase until con¬ servatism, prejudice, and dogmatism, which are the chief obstacles against educational reform, are swept away by the rising tide of pub¬ lic opinion in favor of progress in this direction. Unsymmetrical Mental Development.— A marked tendency of the times is toward the selection of specialties, not only in the profes¬ sions, but in all departments of life. This seems to be necessary on two accounts : 1. The accumulated facts in the various departments of human knowledge is so great that a single mind cannot hope to grasp all. The best an individual can do is to become thoroughly conversant with one or two arts or sciences. Human life is not long enough, even if the capacity of the brain were sufficient, which there is reason to doubt, to master all that is known in the various subjects of study. 2. Some persons are born with a peculiar fitness for certain pur¬ suits, mental or muscular, or both, and hence they will be most likely to succeed in those particular pursuits. This tendency, although it seems to be a natural outgrowth of the present state of society and of the world, and a necessary result of a high grade of culture, is never¬ theless detrimental to the individual. While it benefits society as a whole, making it more perfect than it could otherwise be, the gain of society is at the expense of its individual members, or of some of them at least. By the undue development of certain faculties to the neglect of others, the sum total of brain force is weakened, and the brain becomes a monstrosity, and the mind a distortion. It is more than probable that this specialization of labor and of mental develop¬ ment is one of the causes which induce, at first eccentricity and after¬ ward actual insanity, which is but one step removed from well-marked eccentricity. It is far better for each individual to acquire as equable a development as possible, mentally, physically, and morally ; each one should endeavor to acquire as much as possible of this equable culture, as it will add force and endurance to the mind, even should STIMULANTS AND NARCOTICS. 165 the individual afterward become a specialist in some branch of knowledge. O Evils of Excessive Brain-Labor.— While a proper amount of brain-labor is in the highest degree wholesome and conducive to lon¬ gevity, as already shown, too much mental work is harmful in a high degree. The brain wears rapidly, and requires abundant time for rest and repair in sleep; when this is supplied, almost any amount of work may be performed which is possible to the individual. Brain- worry wears much faster than work, and to it should be attributed much that has been charged to brain-work. Physiologists have shown that three hours of severe mental labor exhausts the system as much as ten hours of severe physical labor, which leads to the conclusion that less time should be spent in mental labor than is usually spent in muscular labor between the intervals of rest. The student or profes¬ sional man who goads his brain into activity when it is exhausted by want of sleep or long and severe labor, commits a crime against him¬ self. The strongest mind will eventually break down under such usage. When the brain is weary, and thought is laborious, rest is re¬ quired, and it should be secured. Pernicious Effects of Stimulants and Narcotics.— Brain-work¬ ers are of all classes the most strongly tempted to make use of ex¬ citants to enable them to obtain from their tired nerves a little more work than they are capable of doing with safety. Alcohol, tobacco, tea, coffee, and chocolate are all used for this purpose, and with ap¬ parent advantage in some cases, temporarily at least. But the ad¬ vantage is only apparent. These drugs, and all others which operate in a kindred manner, are deceptive; they make a person believe he is not tired, when he is exhausted; they make him think he is warm, when he is really cold. They make him believe he is strong, when he is weak. Their use is most pernicious in its effects, since it more than doubles the danger from overwork. When in a natural condition, a man can tell by his feelings when he has gone to the full limit of his powers of endurance; but when his nerves are stupefied by alcohol or tobacco, or exhilarated with tea or coffee, he has no landmarks; he is at sea, and ls certain to meet with disaster and shipwreck unless he change his course. This subject is more fully considered in a chapter devoted to the subject, to which the reader’s attention is invited. 166 ANATOMY, PHYSIOLOGY , AAD HYGIENE. THE ORGANS OF SPECIAL SENSE. In such low forms of life as the mussel and the earth-worm, what little sensation is present is of a very simple kind. As we rise higher in the scale of being, the general property of sensibility is modified to meet the wants of the higher order of existence, and special properties are developed. In man, in whom is found the highest type of sensi¬ bility, there are, in addition to the general sensibility which pervades the whole body, seven varieties of sensation, termed the special senses. Formerly there were enumerated but five, hearing, seeing, smelling, tasting, and feeling ; but two others have been added within a few years, the sense of temperature, and the muscular sense, or the sense of weight. Each of the first five of these requires a special organ for its manifestation ; to the study of these organs of the special senses and their functions we will now give our attention, considering the simpler organs first, and so gradually approaching the more complicated, which are undoubtedly the most wonderful exhibitions of delicate organiza¬ tion and perfect adaptation of means to ends in the body. THE SKIN. The skin contains the organs of touch, but cannot itself be called the organ of touch, as it performs several other functions, some of which are fully as important as this. The mucous membrane of the mouth and nose also possesses tactile sense. The skin is composed of two principal layers, which are easily separated, after death, by maceration in water. The inner of the two is the true skin, or cutis vera, in which are located all the organs and elements to which the functions of the skin are due. The basis of the structure of the skin is a dense network of elastic fibres, among which are closelv interwoven minute blood-vessels, nerve filaments, and lymphatic or absorbent vessels. The skin also contains little pockets, or follicles, from which the hair grows, each hair from a single follicle. Closely connected with the hair follicles are small glands, the function of which is the production of fatty or sebaceous matter. Here are also found the perspiratory or sweat glands, which will be more accurately described elsewhere. Another interesting element of the true skin is involuntary muscular fibre, the contraction of which draws the skin into the peculiar condi¬ tion known as goose-flesh. Plate I V. THE S 'KIN. Showing a Vertical Section of the Skin, greatly magnified. a. a. Hairs m their follicles, connected with which are the Sebaceous Glands ; c. Sweat Gland with its duct ; d. d. Blood-Vessels. THE SENSE OF TOUCH. 1G7 The cuticle, or epidermis, is wholly made up of cells, which are pro¬ duced by the true skin beneath. As the cells grow older they become shrunken and dead, and are gradually pushed out to the surface, becom¬ ing dried and falling oft’ as new cells are pushed out beneath. These dead cells give to the epidermis a horny character, and when viewed with a microscope its outer layers are seen to be composed of delicate little scales, which are the dead cells referred to. The lower part of the epidermis contains colored cells, upon which the color of the skin in dif¬ ferent persons and different races depends. In the negro these cells are abundant, giving to the skin a black color. In the lighter races they are less abundant, there being very few in the skin of the Caucasian, and none at all in the albino, whose transparent epidermis shows very clearly the red color of the living tissues beneath, with their abundant supply of blood-vessels. The thickness of the cuticle varies in different parts of the body and in different persons. Its use is to protect the true skin beneath. The structure of the skin is very well shown in Plate IV. The nerves of touch terminate in the true skin, in a variety of ways. It is probable that in the majority of instances they end in the hair fol¬ licles already mentioned ; but in the parts of the body in which the sense of touch is most acute, as the hands, a special arrangement to give the greatest possible delicacy is provided. This consists of what is known as tactile corpuscles, which are cone-shaped, corpuscular, resist¬ ing bodies located in the papillaa of the skin, as shown in the plate. The nerve fibi'es which convey tactile impressions terminate in these bodies, after coiling two or three times among them. The resistance which the corpuscles afford, adds greatly to the delicacy of the sense of touch. It is their presence in large numbers at the ends of the fin¬ gers which gives to tins part of the skin such accuracy of touch. More than one hundred of these corpuscles were counted in a space near the end of a finger -fa of an inch square, which would make more than 200,000 to the square inch. The Sense of Touch. — Of the seven special senses this is undoubt¬ edly the most simple ; yet through it we learn many of the most im¬ portant facts which we possess concerning external objects. We learn by it such properties of objects as size, form, and character of surface as to smoothness or roughness. The sense of touch greatly assists the other senses in acquiring correct ideas of the nature of bodies. We are rarely fully conscious of our real dependence upon this sense, or of the degree 168 ANATOMY, PHYSIOLOGY , AND HYGIENE. to which it may be developed, until deprived of some of the other senses, especially sight. Numerous examples are given of persons who, upon losing their sight, have been enabled to develop their sense of touch to such a degree as to be really marvelous. Probably one reason for this remarkable increase in the delicacy and efficiency of touch is the concen¬ tration of the attention upon it when the sight is absent from birth, or has been destroyed. The sense of touch differs greatly in delicacy in different parts of the body. The acuteness of the tactile sense in any part may be readily tested by observing the distance at which two pin points may be placed from each other without being recognized as two distinct objects. For example, two points applied in this way to the hand, will be recognized as two when but a slight distance apart ; while upon the back they may be removed some considerable distance without being distinguished as more than one object. In this way the ■whole skin has been tested, the results showing that of all parts, the tip of the tongue is the most sensitive, recognizing points which are not more than one-twenty-fifth of an inch apart. The tips of the fingers rank next in sensibility, dis tingulshing objects which are no nearer to each other than one-seven¬ teenth of an inch. F rom the tips of the fingers the acuteness of touch rapidly diminishes as we recede, being represented by a distance of one- seventh inch at the portion of the finger next the palm of the hand, one- third on the back of the fingers, three-fifths on the back of the hand, two-thirds on the skin of the throat, one and one-half inches on the sternum, and two inches at the middle of the back. The cheek is much more sensi¬ tive than the back of the hand, recognizing objects at one-third of an inch. Objects are recog¬ nized on the dorsum of the foot at a distance of one inch. The sense of touch may be regarded as one of the most reliable of all the senses ; yet we are liable to deception by it if impressions are re¬ ceived in a manner different from that in which they usually are. This fact is illustrated by an experiment the origin of which dates back to Aristotle. If two fingers be crossed as shown in Fig. 77, and a small THE MUSCULAR SENSE. 1G9 object placed between the ends, the impression will be that two objects are felt. The reason of this evidently is that by crossing the fingers the two sides of the fingers opposed are such as have been taught to dis¬ tinguish separate objects, and they tell the same story which they have been educated to tell, notwithstanding it does not agree with the facts. This shows clearly that the action of the nerves as well as that of the brain is largely the result of education. An illustration of the same fact is bo be found in a surgical operation sometimes performed for the restoration of a nose which has been destroyed by accident or dis¬ ease. In this operation the skin of the forehead is brought down and made to grow into the form of a nose ; but the sense of touch still re¬ tains the old position, so that when the new nose is touched, the impres¬ sion is conveyed to the brain that the forehead has been touched. After a few' months, however, the sense of touch is educated to recognize its newr position, and the difficulty is overcome. So with persons who have suffered amputation of a limb ; they con¬ tinue to feel the fingers or toes for some time. Persons have even claimed to feel actions which really occurred in amputated limbs. Such claims are, however, wholly based on the imagination. The phe¬ nomenon is due to the fact to v'hich attention has j ust been called, that the nerves form the habit of carrying impressions from certain points, and whenever irritated in any way, carry the same impression even if they are no longer connected with the original points. The deception gradually fades av'ay, the nerves by degrees becoming accustomed to their new condition, so that the amputated limb seems to grow' grad¬ ually shorter and shorter until its real condition is correctly recognized by the nerves. THE MUSCULAR SENSE, The sense by w'hich weight is appreciated, or the muscular sense, is supposed to be located in the muscles. It is evidently distinct from the sense of touch, because the tactile sense may be wholly obliterated by disease while the muscular sense remains. It is this sense which enables a person to j udge of the weight of an object, and to adjust his outlay of strength to the object to be lifted. If it w'ere not for this sense our movements w'ould be very irregular and spasmodic. 170 ANATOMY, PHYSIOLOGY, AND HYGIENE. THE SENSE OF TEMPERATURE. This sense bears a close relation to the tactile sense, but is aLo proven to be different because it often exists when the sense of touch has been lost by disease, and Is sometimes lost while the tactile sense remains intact. By means of this sense we are able to determine degrees of temperature within certain limits. When an object wThich is very hot is brought in contact with the skin, the sensation is of pain, rather than of heat. It is a curious fact that the effect upon the nerves of sense as well as upon the tissues is essentially the same whether the object be very hot or very cold. The thermal sense is not an accurate measure of heat, since, as with all other forms of sensibility, its impressions are relative rather than positive. This is well shown by a simple experiment. Place in three vessels a quantity of water of different temperatures, making that in the first vessel very cold, that in the third very hot, and that in the sec¬ ond intermediate between the two. Place one hand in the cold water and the other in the hot, holding them in the water one or two min¬ utes. Then put first one hand and then the other into the middle vessel of water at the medium temperature. The curioffs fact will be ob¬ served that each hand tells a different story about the temperature of the water in this vessel. The one which has been in the hot water says it is cold, while the other hand, which was removed from the vessel of cold water, declares that it is warm. From this experiment it is clear that our ideas of temperature gained through the thermal sense are only relative. It is also worthy of notice that the apparent temperature of ob¬ jects depends in a great measure upon their character. An object which is a good conductor of heat seems to possess a much higher temperature than one which is a poor conductor, although the abso¬ lute temperature of both may be exactly the same. It is this fact which causes metals and liquids to seem warmer at a given tempera¬ ture than gases and solid objects composed of such poor conductors as wood, straw, hair, and similar substances. Liquids of a higher tem¬ perature than 120° can be borne but for an instant, while vapor of 140° or 150° can be endured without pain, and the whole body may be im¬ mersed in hot air at a temperature of 250° and upward with impu¬ nity. We have remained some minutes in a room of this temperature without the slightest injury; and persons have been known to en¬ dure a very much higher temperature in perfectly dry air. THE SENSE OF TASTE. 171 THE SENSE OF TASTE, The sense of taste, or gustatory sense, is located in the mucous membrane of the tongue, being attributable to two nerves, one of which is distributed in the anterior portion of the organ, and the other in the mucous membrane of the back part of the tongue and mouth. The terminal filaments of these nerves seem to end in little promi¬ nences with which the membrane is closely studded, which are known as 'papillce. The larger of these are supposed to be devoted to the sense of taste, while the smaller contain nerves of touch and of the thermal sense, both of which forms of sensibility are possessed by the tongue in a high degree, especially by its tip, which possesses the most delicate tactile sense of any part of the body. This portion is not quite so sensitive to taste as the posterior portion of the organ. The sense of taste, like the senses of touch, weight, and tempera¬ ture, is exercised only upon bodies which come in immediate contact with it. In the case of taste, however, mere mechanical contact is not sufficient. An object to be appreciated by the gustatory sense must be dissolved, so that it may come in direct contact with the nerves of taste by penetrating the papillie in which they terminate ; hence, any substances placed upon the tongue when dry, will not be tasted until dissolved, if at all ; and insoluble substances evidently can possess no gustatory properties. When the tongue becomes* “ coated ” or “ furred,” as it often does in sickness, the sense of taste is greatly lessened in acuteness, which accounts in a great degree for the insipidness of foods and drinks so often complained of at those times. Physiological experiments seem to show that the sense of taste is confined to the tip, edges, and back portion of the tongue, and the back portion of the roof of the mouth and the soft palate, being ab¬ sent from the lips, gums, middle of dorsum or back of tongue and its under side, and from the front part of the roof of the mouth. Tastes are classified as acid, saline, bitter, and sweet, though it is evident that there are many flavors which are not included in this classification, and which cannot be accurately described. Of these different tastes it is curiously observed that those of a saline and bit¬ ter character are best appreciated by the back portion of the tongue, and sweet and acid flavors by the anterior portion. Some physiolo¬ gists claim that acids are best appreciated by the sides of the tongue. All of these various tastes seem to he increased by friction of the 172 ANATOMY, PHYSIOLOGY, AND HYGIENE. tongue against the roof and sides of the mouth, which is probably due to the diffusion of the sapid substance. Taste Aided by other Senses. — Many of the properties of sub¬ stances appreciated in the mouth prove, upon careful examination, to be recognized by other senses than that of taste, although credit is given to the latter. For instance, people often speak of astringent, oily, mealy, watery, smooth, burning or pungent, and cool tastes, when in reality these are not tastes at all, but are properties recognized by the senses of touch and temperature. So, also, substances are spoken of as having strong tastes when they have very little taste indeed, but are simply smelled when in the mouth. Sight is also an aid to the sense of taste by exciting agreeable anticipations. The Uses of Taste. — Besides being a source of gratification, the sense of taste is useful as a guide in the selection of food. As a gen¬ eral rule, substances which are unpalatable, repugnant to the taste, are unwholesome. There are, it is true, cases of individual idiosyn¬ crasy in which the sense of taste rejects articles which are really wholesome ; but even in these cases the taste may many times be a correct guide, as the digestive organs are in close sympathy with the gustatory sense and might resent the usually wholesome aliment on account of the same unexplainable peculiarity. The taste is susceptible of education in a very high degree. Even the most repugnant substances may by degrees be made acceptable. Tastes vary greatly in different countries, one nation considering as a delicacy what would be most loathsome to others. For instance, noth¬ ing could be more repulsive to the palate of a Frenchman than the putrid flesh considered as a delicacy by some nations ; and it is quite likely that the latter would consider equally disgusting the asafetida which the former sometimes employs as a flavor in his dainty dishes. Electrical Excitement of the Sense of Taste. — The sense of taste may be excited by a current of electricity as well as by sapid substances. A very simple experiment will illustrate this fact. Place upon the upper side of the tongue a piece of brightly polished zinc, and upon the under side a large copper penny or a silver half-dollar, bringing the edges of the two metals together at the tip of the tongue. In a few seconds a very strong metallic taste will be experienced. If the positive pole of a battery be touched to the tongue, while the other is held in the hand, an alkaline taste will be experienced ; and the ap¬ plication of the negative pole will produce a strongly acid taste. We THE ORGANS OF SMELL. 173 have frequently observed in practice that excitation of the nerve of taste is often felt by patients during the application of galvanism to other parts of the body. THE ORGANS OF SMELL. The organ of smell, or the olfactory sense, is located in the upper part of the nasal cavity, the mucous membrane of which part receives the branches of the olfactory nerve which are sent down from the ol¬ factory bulbs — a portion of the brain located just above — through a large number of very small openings in the floor of the skull, provided for this purpose. The balance of the mucous membrane of the nose is supplied with branches from the general sensory nerve of the face, and has nothing to do with the sense of smell. The ends of the ol¬ factory nerves are not imbedded in the mucous membrane as are the nerves of taste and the sensory nerves, but are exposed with a very slight covering of epithelium, so that they may receive more delicate impressions. Smell is produced by the actual contact of odorous par¬ ticles with the nerve filaments. It seems also to be necessary that these particles should be brought to the nose suspended in the air ; since the nasal cavity may be filled with rose-water, the odor of which is very marked, without exciting the sense of smell in the slightest degree. Although a certain degree of moisture is necessarily main¬ tained, the presence of a large amount of fluid interferes with the function of smell altogether. In ordinary breathing, the air taken in through the nose passes only through its lower passages, and does not come in direct or immediate contact with the nerves of smell in the upper portion of the cavity ; but odorous particles in the air reach the nerves of smell by diffusion of the air upward. By the act of sniffing, however, which is instinctively performed when we wish to intensify the sense of smell, the air is forcibly drawn up into the up¬ per part of the nasal cavity, and thus brings a larger number of parti¬ cles in contact with the olfactory nerve than in ordinary respiration. We are able, by means of the olfactory sense, to appreciate a very great variety of odors, the number of which is so great as to make almost utterly impossible any attempt to classify them. These odors can not only be distinguished when presented separately, but also when mingled they can be recognized individually. The quantity of material necessary to excite the sense of smell is exceedingly minute. A single grain of musk will fill a room with its odor for many years without appreciably diminishing in weight. 174 ANATOMY , PHYSIOLOGY, AND HYGIENE. It is a curious fact that mental impressions and associations are more closely connected with smell than with any other sense. Many persons are so susceptible in this regard that a very slight excitation of the sense with certain odors will cause them to faint. Uses of the Sense of Smell. — In addition to affording a great amount of pleasure by enabling us to recognize the numerous del¬ icate and pleasing perfumes which abound in nature, especially in the botanical world, the sense of smell apprizes us of unwholesome con¬ stituents in the air, and of our proximity to sources of injury to health. The olfactory sense thus protects not only the lungs and other respiratory organs, by enabling us to avoid irritating gases which might cause serious injury to the whole system, but it is also useful to enable us to judge of the properties of food, and to stimulate the appetite and the action of the organs of digestion. It is not true that all harmful substances possess bad odors, but it is almost univer¬ sally true that substances possessing an unpleasant odor are not wholesome. The sense of smell is a valuable sentinel to the citadel of life, and ought to be carefully guarded and protected. It may be educated to a great degree of delicacy. As a general rule the lower orders of animals possess this sense in a much more acute degree than man. Wild animals will scent their prey or their enemies at a great distance. The keenness of scent in the dog is marvelous. This doubtless depends largely upon the fact that in animals of this class the olfactory nerve is spread over a much larger space than in man. In barbarous tribes the sense seems to be much more highly developed than in civilized man. Humboldt, the great naturalist and traveler, states that the natives of Peru can dis¬ tinguish in the dark between different races by this sense. HEARING: THE AUDITORY SENSE, The organ of hearing consists of three parts : 1. The external ear, a trumpet-shaped portion for collecting sounds ; 2. The middle ear, or tympanum, a cavity separated from the external ear by a mem¬ brane resembling a drum-head in its character and use, and contain¬ ing several delicate bones, or ossicles, which play an important part in the action of the ear ; 3. The internal ear, or labyrinth, which con¬ tains the terminal filaments of the auditory nerve and delicate appa¬ ratus connected with the reception of auditory impressions of various kinds. THE EXTERNAL EAR. 175 The External Ear. — The external portion of the ear consists of a framework of cartilage covered with skin, having a shape somewhat like that of a conch-shell. It is attached to the hones of the head in such a manner as to be easily movable within small limits. In lower animals the various movements admissible are produced by a special set of muscles for the purpose. In man these muscles are usually so slightly devel¬ oped that they are capable of producing no perceptible mo¬ tion, only in very exceptional instances. The outer portion of the ear is connected with the middle ear by means of a slightly curved canal about one and one-fourth inches in length, across the bottom of which is stretched the outer boundary of the middle ear. This canal is lined by a continuation of the skin of the ear, which here becomes very thin and sensitive, and contains glands that resemble the sweat glands found in other parts of the skin but which here secrete a waxy substance called cerumen, of an intensely bitter taste, the probable object of which is to guard the ear against the entrance of insects. Numerous fine hairs here found doubtless assist in protect¬ ing the ear from insects, dust, and other foreign bodies. The ear-wax is usually produced in small quantity, and dries and falls from the ear in thin scales. Fig-. 78. The Ear. The ent shows the External Auditory Canal, the Middle Ear with the Ossicles, and the Internal Ear. The Middle Ear. — The middle ear, or tympanum, is a cavity placed between the external and internal ears. Its structure is such as to remind one of a drum. The cavity consists of a little hollow in the temporal bone of the head, the outer side of which is bounded by a membrane which separates it from the outer ear and is known as the membrana tympani. Its inner side also presents an opening which is covered in a somewhat similar manner. The tympanum is not a closed cavity, as it communicates with the throat or back part of the nasal cavity by means of a small canal known as the Eusta¬ chian tube. 176 ANATOMY , PHYSIOLOGY, AND HYGIENE. The Ear-Bones. — The middle ear contains in its cavity a chain of hones, three in number, reaching across from one side to the other. These delicate bony structures have received names corresponding to their different shapes. The first, being shaped like a mallet, is called the malleus ; the second, from its resemblance to a blacksmith’s an- Fig. 79. Bones of the Ear. a. Malleus; 5. Incus; c. Stapes. vil, is known as the incus, which has that signification ; and the third, from its resemblance to a stirrup, is called the stapes. The first of these bones is attached by its longer part, or handle, to the drum membrane. All the bones are connected by delicate joints, and the innermost bone, the stapes, fits into an opening in the opposite wall of the middle ear by which it is connected with the internal ear. Connected with the ear-bones and the drum membrane are three delicate muscles, the smallest in the body, which by their action reg¬ ulate the movements of these parts. Two of these are attached to the drum membrane, their use being to relax it and to render it tense, and the other to the stapes. The Internal Ear. — This is one of the most delicate and com- ' plicated mechanisms in the body. Owing to its complex structure and tortuous canals, it is called the labyrinth. This is the most es¬ sential part of the auditory apparatus. It is placed in a hollow in the densest part of the temporal bone. It may be divided into three parts : 1. The vestibule, or ante -chamber ; 2. The cochlea, or snail- shell ; 3. The semi-circular canals. The vestibule, semi-circular canals, and cochlea are all filled with a limpid fluid. Suspended in this fluid by means of delicate bands of fibrous tissue placed like braces on all sides, is a membranous sac also filled with fluid, which corresponds in shape exactly to the form of the vestibule, canals, and cochlea. In the walls of this sac are found the terminations of the auditory nerve. The inner surface of the membranous sac presents a most wonder- TEE NATURE OF SOUND. 177 ful structure. Lining the sac in places are cells of various shapes, some of which bear upon their outer surface a number of minute, but sharp, stiff hairs. These cells are connected with the fibres of the audi¬ tory nerve, and it is supposed that the fine hairs described are really the extreme ends of the nerve filaments, which are thus bathed in the limpid fluid which fills the whole internal ear. Within the sac are also to be found curious little chalky particles called otoliths, or ear-sand. Physiology of the Ear. — Having briefly described the structure of the ear, we will now proceed to give a con¬ cise account of its functions. The chief duty of this organ is to receive impressions of sound, and to note the differences between various sounds in force, pitch, and qual¬ ity. In order to comprehend how this is done we must understand something of the nature of sound. Fig-. 80. The Internal Ear. The Nature of Sound. — If a stone be dropped into the water, a series of circular waves extend out from the point at which the stone entered the water. These waves are caused by vibration of the water, which is produced by the motion communicated to it by the stone. In a similar manner, moving bodies communicate motion to the air. A fan, gently moved by the hand, produces waves in the air which may be felt, though not heard. The wings of a humming-bird or an insect fan the air so rapidly that waves are produced which can be recognized by the ear. This is what is termed sound. The range of sounds which can be appreciated by the human ear is very great, the lowest being produced by sixteen vibrations per second, and the highest by about forty-eight thousand vibrations per second, equivalent to a range of about eleven and one-half octaves. Persons differ in their capacity for appreciating sounds, some being able to hear lower sounds than others, and vice versa. It is also probable that lower animals differ from each other and from man in this re¬ spect. There is at least good reason for believing that some insects 12 178 ANATOMY , PHYSIOLOGY , ^VZ> HYGIENE. are capable of making sounds which are produced by vibrations too rapid to be appreciated by the human ear, though they may be heard by the insects themselves. Some years ago an eminent European sci¬ entist devised an experiment by which he was able to demonstrate not only that vibrations of air much more rapid than can be detected by the human ear can be produced, but that these extremely acute vi¬ brations possess the same qualities as those less rapid, except that they cannot be perceived by the ear. * Sounds are generally divided into musical sounds and noises, al¬ though this is a purely arbitrary division, as in reality no exact line can be drawn between these two classes of sounds. It is generally understood, however, that a musical sound is one that is produced by regular vibrations, or those which are repeated at regular intervals, while noises consist of irregular and discordant vibrations occurring at O O irregular intervals. The question sometimes discussed with so much display of argu¬ ment on both sides, whether there would be sound if there were no ears, we need hardly notice here ; it will be at least sufficient to say that the settlement of the question wholly depends upon whether it is viewed from the standpoint of the physiologist or that of the phys¬ icist. The physiologist regards sound as the sensation produced upon the ear by certain vibrations of air ; the physicist studies as sound the air-waves which produce the sensation upon the auditory nerve. How wc Hear. — The operation of hearing is a very interesting one, and becomes quite simple when the structure of the hearing ap¬ paratus is well understood, since there is provided for each necessary part of the operation an organ or series of organs well adapted to ac¬ complish the work. When the air is set in motion by a rapidly vi¬ brating body, the sound-waves are collected by the external ear and concentrated in the short canal at the inner end of which the drum membrane is placed. The motion of the air is communicated to the drum membrane, and by its movement the ear bones are caused to oscillate, and thus transmit the vibration to the fluid which fills the internal ear. The vibration readily extends from the fluid in the vestibule and its communicating cavities to the membranous sac which it contains, and to the limpid fluid contained in the sac. The motion of this fluid causes vibration of the delicate hairs which pro¬ ject into it, and which, as we have seen, are undoubtedly the ends of USE OF TIIE EUSTACHIAN TUBE. 179 the filaments of the nerve of hearing. Thus the external air-waves have been conducted to the auditory nerve, by which the impression is carried to the auditory center at the base of the brain, which in turn transmits it to the cerebrum, the seat of the intellect, and then the sound is recognized. The Musical Instrument of the Ear.— From the peculiar struct¬ ure of the cochlea it is believed that this part of the internal ear is devoted to the recognition of musical sounds, and especiallv to the pitch of sounds. There is in its structure so close a resemblance to the strings of a piano and the accessory apparatus that physiologists who have studied this part have universally remarked the analogy. There is even a damping arrangement, or what seems to be such, for the purpose of preventing the confusion of sounds when they are re¬ ceived in rapid succession. It was formerly supposed that the oto¬ liths had something to do with the production of sound, but it is now conceded that their action, if they have any, is not known. The Accommodation of Hearing. — Experiments concerning the action of stretched membranes with reference to sounds of various pitch have shown that the tension of the membrane must be varied for differences in pitch in order that they may be heard the best. For the safety of the ear it is also important that there should be some means of relaxing the membrane and the accessory organs so that injury shall not be received from very loud sounds. These needs are supplied by the delicate muscles of the drumhead and the stapes. Use of the Eustachian Tube. — The object of this canal is to equalize the atmospheric pressure in the drum or middle ear with that outside. The pressure of the atmosphere is constantly changing, as is indicated by the changes in the barometer ; hence, if no provis¬ ion of this sort were made, the drum membrane would sometimes be pressed outward, and sometimes inward, which would greatly inter¬ fere with its function. This is well seen when the tube becomes closed up in consequence of a cold, which not infrequently happens ; at such times the hearing is greatly obstructed. The Eustachian tube also comes into use when persons ascend to great heights by going up in a balloon or climbing mountains ; also, in the cases of persons who work under water by means of diving-bells. The walls of the tube usually lie in contact, so when changes in the internal and ex¬ ternal pressure are made rapidly it sometimes becomes necessary to 180 ANATOMY, PHYSIOLOGY, AND HYGIENE. assist nature in changing the volume of air in the ears. This is real- ily done bv a very simple means which any one can employ. After taking a deep breath close the lips tightly, and close the nostrils with the fingers by pressing them firmly together ; then attempt to ex¬ pel the air through the nose, as in blowing the nose, but still keep it tightly closed. By this maneuver the Eustachian tube will be opened and air forced into the drum. This procedure is found to be a very important one with divers who descend to their work under an im¬ mense bell. The weight of the water causes a very great increase in the pressure of the air in the bell upon the drum membrane. When persons so engaged neglect to observe this precaution, the membrane is not infrequently ruptured. Source of the Power of Maintaining Equilibrium. — Careful examination of the walls of the semi-circular canals of the internal ear have shown that they do not contain fibres from the auditory nerve, and hence do not take an active part in the process of hearing. For some time it was a source of great perplexity to decide the func¬ tion of these curious structures. At last an ingenious physiologist in¬ stituted a series of experiments on these organs in birds; and he found that their function is to aid in maintaining an equilibrium, by giving information respecting changes in position of the head. The manner in which this is done is very remarkable and interesting, but the process is too complicated for explanation here. It may be re¬ marked, however, that the function is based upon the well-known fact that fluids contained in vessels have a strong tendency to retain their actual position instead of changing with every movement of the containing vessel. For instance, a glass containing water may be turned around without tinning the water. The semi-circular canals contain a limpid fluid closely resembling water, and the three canals are so placed with reference to each other that the effect of any change of position may be noted by the change in the walls of the canals with reference to the fluid contained within them. This fact may explain the dizziness which often accompanies disease of the ear, the explanation being that in these cases the part of the ear is affected, the duty of which is to apprise the brain of the muscular actions nec¬ essary to maintain the equilibrium of the body. How Direction of Sounds is Determined.— The direction of sounds is probably determined by changing the position of the head and observing the direction in which the sound is most distinctly THE SENSE OF HEARING. 181 heard. Most lower animals can accomplish the same end in a large degree by changing the position of the ear by means of the muscles which they possess for that purpose, but which in man are not suffi¬ ciently developed to be of use. Our power to determine the direction of sounds is quite limited, as also is the power to determine the distance from which sounds come which fall upon the ear. That is, it is very difficult, often impossible, to distinguish between a feeble sound and one which comes from a distance. Interesting Facts about the Sense of Hearing. — Like most of the other senses, the ear refers its impression to the outside. It is a curious fact, however, that if the external ear be filled with water, this is no longer the case ; sounds then seem to originate and to be O' O located within the head. The ear exceeds all the other senses in acuteness of perception. If impressions are made upon the eye in so rapid succession as ten in a second, they become fused ; that is, they run together and become in¬ distinguishable. In the case of the ear, however, sounds which follow one another with the rapidity of one hundred a second, as in the tick¬ ing of a fast-beating pendulum, are heard as distinct sounds. It is a common observation that some people have not “ a musical ear.” This is owing to the fact that they cannot readily distinguish one tone from another. Ears which are well trained can distinguish between notes which differ less than the one-hundreth part of a tone. Notes higher than 4000 vibrations per second are, however, distin¬ guished with great difficulty. It is a commonly known fact that the ticking of a watch may be heard much more distinctly when held between the teeth than when at the same distance from the ear and not in contact with the teeth. Two new instruments for the relief of deafness have recently been invented which are based on this principle, known as the audipltone and the dentaplione. By the aid of these instruments the sound¬ waves are conducted to the internal ear through the bones of the head. It is probable that the drum membrane acts as when sounds are received in the ordinary way when present. It is said that by means of these instruments persons who were born deaf have been made to hear. These instruments have not yet been sufficiently tested to make it safe to recommend them, though they are undoubt¬ edly useful for some cases. 182 ANATOMY, PHYSIOLOGY, AND HYGIENE. THE EYE AND ITS FUNCTIONS. The organ of vision consists essentially of two parts, the optical instrument itself, or the eye-ball, and the accessory organs and envel¬ oping parts. The latter, which we will describe first, consist of the orbit , the eyelids , and the lachrymal or tear apparatus. Fig. 81. The Eye, showing at its inner border the appara¬ tus for removing the tears from the eye. The Orbit. — In or¬ der to protect it from mechanical injury, the eye is placed in a deep socket formed by the bones of the cranium and face. The edges of the socket project so much beyond the eye¬ ball that it will readily escape injury, even should a blow be re¬ ceived upon that part of the face, unless from a small instrument aimed directly at the eye. The overhanging brow is covered with short hairs so arranged as to conduct away the perspiration when a person is sweating freely, and prevent its entering the eye. An opening in the bottom of this bony socket gives entrance to the nerve of sight, which passes into the eye-ball. In the back part of the orbit is to be found a large amount of fatty tissue, which forms a sort of cushion for the eye-ball to pro¬ tect it from any injury from jar. The Eyelids . — The eye is protected in front by two movable cur¬ tains, the eyelids, the upper of which is the larger, and moves very freely, the lower being short and having little motion. The lids are chiefly composed of skin, lined with a delicate mucous membrane known as the conjunctiva. The edges of the lids present a row of fine hairs, the eyelashes, which protect the eye from dust, and when the lids are partially closed, diminish the amount of light that may enter the eye. Just within the row of eyelashes may be seen a line of delicate points which are the mouths of ducts leading from minute sebaceous glands which secrete an oily substance and pour it out upon the edge of the lids, by means of which they are prevented from ad- THE LACHRYMAL APPARATUS. 1S3 liering together during sleep. By the same means the lachrymal fluid which lubricates the eye is prevented from overflowing upon the cheek. The Lachrymal Apparatus. — Just within the outer and upper border of the orbit is placed a lit¬ tle gland, the func¬ tion of which is to secrete a limpid, lu¬ bricating fluid, the O 1 lachrymal fluid, or tears, from which fact it is called the lachrymal gland. The fluid formed flows down a n d across the eye, moist¬ ening its whole anterior surface, and is drained off at the lower and internal angle of the eye by the nasal duct, a canal which leads to the nose. This fluid protects the eye both by washing away impu¬ rities and by keeping it transparent. When the cornea, or trans¬ parent part of the eye, becomes dry, it loses its lustre and becomes partially opaque. This is well seen in fishes when they have been removed from the water for some time. They have no lachrymal apparatus, since their natural element, the water in which they swim, answers the same purpose. In the edge of each lid, at the inner end, are little openings through which the tears are drained off into the nasal duct and so Figr. 82. The Glandular Apparatus of the Eye; 7. Lachrymal Gland. 8, 9, 10, Ducts. 11. Openings of ducts on inner border of upper lid ; 6. Glands for lubricating edges of eyelids. conveyed to the nose. These can be seen in the lower lids by draw¬ ing them downward and forward. O The secretion of the lachrymal fluid is constant, but only in sufficient quantity for the purpose of lubricating the eye, except when the mind is laboring under the influence of some strong emotion, when it is poured out in such quantities that it escapes over the lids upon the cheek in tears. Irritating substances in the eye, a harsh, dry wind, and irritating vapors, produce the same effect. 184 ANATOMY, PHYSIOLOGY, AND HYGIENE. The Eye-Ball . — The ball of the eye, which is the essential instru¬ ment of sight, in many respects resembles the camera of the photo¬ grapher, as will be seen from the description. The eye-ball is not per¬ fectly spherical in shape, though approaching the form of a globe. Its average diameter is about an inch. It is composed, essentially, of three investing membranes or coats, called tunics, and three transparent me¬ dia inclosed, called humors. Fig. 83. Vertical Section of the Eye-Ball. a. Eyelashes; d. Eyelids; i. Cornea; V. Aqueous Humor; t. Crystalline Lens ; s. Vitreous Humor; m. Iris; o. Retina. The outermost tunic is called the sclerotic. It is a tough, fibrous coat, and forms what is known as the white of the eye. It covers the whole eye-ball with the exception of a small circular portion which is covered by a peculiar, horn-like, transparent structure which is a con¬ tinuation of the sclerotic, and is called the cornea. It is this which forms the lustrous portion of the eye, through which its color is seen. The cornea acts as a window to the interior of the eye. Within the sclerotic is another tunic, the choroid, which is a delicate membrane filled with blood-vessels to nourish the eye, and lined upon the inside with a layer of dark, nearly black, coloring matter. The choroid is also absent in front, ending at the margin of the cornea ; but it is continued by a circular curtain called — THE STRUCTURE OF THE IRIS. 185 The Iris. — This delicate structure is what gives to the eye its color. Its outer side is in different persons a great variety of colors, being brown, blue, gray, hazel, and many other shades. Its center is pierced by an opening called the pupil. Its back side is covered, like the choroid, with a layer of black pigment, the object of which is the same as that had in view by the manufacturer of telescopes and microscopes when he covers with a coat of black paint the inside of his instruments, viz., the absorption of wandering rays of light, and the prevention of reflection in the eye, which would occasion confusion of vision. In albinos these dark cells are wanting, in consequence of which they suffer from imperfect vision. The same is true of albinos among lower animals, as white elephants, white rabbits, etc. In blue and gray eyes the pigment cells are less abundant than in black and brown, being found only on the back side of the iris, while in black and brown eyes pigment cells are found upon both sides and in its substance. Dark eyes are usually associated with dark features on account of the general greater abun¬ dance of pigment throughout the body. A careful examination of the iris with the microscope shows that it is made of two sets of fibres, one of which radiates from the center to¬ ward the circumference, while the other is arranged circularly. The circular fibres, by contracting, make the opening through the iris smaller, while the radiating fibres, by contracting, make it larger. Thus the size of the pupil is regulated according to the amount of light which is needed in the eye for the purposes of vision, or which may be tolerated without injury to its delicate structures. The action of the iris of the cat can be very easily seen. When exposed to a bright light, the pupil becomes very small ; but when taken into a room where there is little light, it becomes greatly dilated. It is in part the great power of dila¬ tion of the pupil which enables the cat and the owl to see well where the light is insufficient for most other animals and human beings. When we enter a darkened room we cannot see distinctly for some minutes, as is also the case when we are suddenly brought into the presence of a brio-ht liffht. This is owing: to the fact that time is required for the iris to accommodate the size of the pupil to the amount of light fur¬ nished. When the variation in the intensity of the light is but slight, as is ordinarily the case, no perceptible time is required ; but a longer period is necessary when the difference is great. Every person has experienced temporary inability to see objects distinctly after looking at the sun for a few seconds steadily. 180 ANATOMY, PHYSIOLOGY, AND HYGIENE. Certain drugs possess the power to cause dilatation of the pupil by paralyzing its muscular fibres. Belladonna, one of the chief of these, derives its name, which signifies beautiful lady, from the fact that it has been much used to cause dilatation of the pupil to add brilliance to the eyes. Death has not infrequently been occasioned in this way. The Ciliary Muscle. — Between the sclerotic and the choroid, around the edge of the cornea, is another curious little muscle, known as the ciliary muscle, the use of which will be seen presently. The Retina. — This constitutes the third and inner coat of the eye. It is made up almost wholly of the end filaments of the optic nerve, which enters the ball of the eye at the back side and spreads out into a thin membrane to form the retina. It contains many delicate and cu¬ rious structures connected with vision, but too complicated for explana¬ tion in a popular treatise like this. The retina is sensitive to no im¬ pressions but those produced by light. That is, if otherwise stimulated, it produces only the sensation of light. The Crystalline Lens. — This is the middle one of the three trans¬ parent media of the eye. It is placed in the eye just behind the iris, so that the center of the pupil is just opposite its center. Its shape, as will be seen by reference to Fig. 83, is like that of a convex lens or burn¬ ing-glass. It is of quite firm consistency, feeling to the touch almost as hard as cartilage. It is held in place by means of a delicate sac or cap- • sule which incloses it and is attached by its circumference to the cho¬ roid coat just behind the iris. Its thickness is about one-fourth of an inch. The lens possesses great transparency in health, but sometimes, especially in old age, it becomes opaque, occasioning the disease known as cataract. Attached to the choroid behind the border of the capsule of the lens is the ciliary muscle previously described. The Aqueous Humor. — This is a watery fluid contained in the small space between the lens and the cornea in front. The free inner edge of the iris floats in the aqueous humor. It is this limpid fluid which escapes when the eye is punctured by a sharp instrument. The Yitreous Humor. — Behind the crystalline lens, and filling the greater part of the eye-ball, is the vitreous humor, so called on account of its imagined resemblance to melted glass. This structure is also very transparent. It constitutes about two-thirds of the eye-ball. The ret¬ ina, the inner tunic of the eye, lies in close contact with it. The Physiology of the Eye. — In order to understand the manner in which the mechanism of the eye operates in producing vision, we must PROPERTIES OF LIGHT. 187 first learn something of the nature of light, that with which the eye has to deal. The generally accepted theory of light is what is known as the undulatory theory, which supposes that all space is filled with a sub¬ tile medium known as ether, and that light is simply the waves, or vi¬ brations, or undulations, of this ether, just as sound is the result of the vibrations of air. These vibrations are caused by luminous bodies, as the sun and stars, and by all substances undergoing combustion. Properties of Light. — Objects which allow waves of light to pass through them are called transparent or translucent according to the readiness with which they allow the passage of light. No substance known is perfectly transparent. Even the atmosphere and the purest water are opaque in some degree. Light- waves travel in straight lines, radiating from their source. Those which come from a great distance vary so little in direction that they are considered as parallel. Properties of Lenses.— Fig. 8-1 illustrates the prop¬ erty of a lens to change the direction of rays cf light. The ravs of light which pass from the arrow at the left of the lens have their Figr- 84- Diagram showing the Optical Properties of Lenses. course changed so that they cross at a point upon the right of it and form an image of the ar¬ row inverted. This property of a lens may be readily seen by ex¬ periment with a burning-glass or a pair of convex spectacles of con¬ siderable magnifying power. How We Sec. — In studying the use of the eye in vision, it must be considered first as an optical instrument. As we have already seen, it contains a lens, the shape of which is similar to artificial lenses, and the effect of which in changing the direction of rays of light is precisely the same. The cornea, having a convex surface, also acts as a lens, so that there are virtually two lenses in the eye. When rays of light from an object fall upon the cornea they pass through it and on to the crystalline lens with a different direction from that in which they were received, being brought nearer together, or made to converge. Passing on to the lens they are by it made to converge still more, so that they cross just behind the lens and form an image, reduced in size and inverted, upon the retina. This may be 1SS ANATOMY , PHYSIOLOGY, AND HYGIENE. seen in the eye of an ox taken from the animal immediately after it is killed. By removing the outer coverings at the back part with great care, leaving the retina in place, and then placing it in such a position as to receive a strong light from some object, the object may be seen pictured upon the retina upside down. The delicate nerve cells and filaments which form the retina con¬ vey the impressions thus made upon them to the base of the brain to the nerve center having charge of sight, whence they are communi¬ cated to the cerebrum, and the sensation of sight is produced, or the impressions recognized by the brain. Any sort of irritation of the retina or optic nerve will occasion the sensation of light, whether it be mechanical, or electrical by means of a battery. Accommodation of the Eye. — An opera-glass, when used for view¬ ing objects at different distances, must be adjusted in order to give distinct images of the objects viewed. If turned upon a distant object when rightly adjusted to make a near object distinct, the distant object will appear blurred and indistinct, if seen at all. Like the opera-glass, the telescope, and other similar optical instruments, the eye has an adjusting apparatus. The use of this adjusting mechanism is what is known as accommodation. By its use the healthy eye can be so adjusted as to see with the greatest possible degree of distinct¬ ness objects at the extreme limits of vision, as well as objects very near to the eye. This power differs with different persons in accu¬ racy and in the extent of its limits. A near-sighted person has a very small range of accommodating power, that is, he can see clearly only objects which are within narrow limits of distance. A very simple experiment will make clear to all what is meant by accommodation. Place in a strip of wood two or three feet long, two pins in range with each other, one at either end of the strip. Now hold the strip out horizontally at about the level of the eye, with one end toward the eye. By this arrangement one of the pins will be two or three feet farther from the eye than the other. Now look at the pin nearest the eye. "While doing so it will be observed that an indistinct Anew is also obtained of the pin at the other end, and that it looks blurred. Then look sharp at the pin at the farther end. The pin nearest the eye will now appear blurred and indistinct. This is because the eve cannot accommodate itself to more than one distance •/ at a time. Another interesting experiment shows the same thing in a different way. Make in a card-board two small holes about the clis- VISUAL JUDGMENTS. 189 tance apart shown in Fig. 85, in horizontal line with each other. Place the card very near to the eye, and hold vertically in the fingers a needle at a distance of eight or ten inches from the eye. When the eye is fixed in¬ tently upon the nee¬ dle, it is seen clearly; but if the attention be directed to an object either farther away or nearer by than the needle, it will appear indistinct and also double. If moved near enough to the eye, it will ap¬ pear double continually. The nearest point at which it appears single is the near limit of accommodation. Accommodation is accomplished by the action of the ciliary mus¬ cle, by means of which the form of the lens, and hence its refracting power, is changed, as shown in Fig. 86. Visual Judgments. — With the exception of the auditory sense and the sense of sight, all others of the senses require for their excita¬ tion the actual contact of something. No other sense gives us so much and such varied information respecting external things as the eye ; yet a careful study of the knowledge thus gained shows us that the eye is very greatly aided by the other senses. Indeed, with only the sense of sight, we should be very badly off indeed, and the function of sight would render us but little service. In making visual judgments, or forming opinions which seem to be Fig\ 86. At the rieht of the vertical line, the lens, a a , is shown flattened, as when adjusted for seeing at a distance; on the left, the lens is thickened, as iu near-sighted persons and when examining near objects. Fig:. 5. 190 ANATOMY, T H YSIOLOG Y, AND HYGIENE. based upon the impressions received through the eye, we never take into account our dependence upon other senses, because we are scarcely able to separate them under ordinary circumstances. Judgment of Distance and Size. — The power to judge of dis¬ tance is evidently acquired. The little child reaches out its hand for the moon, undoubtedly supposing it to be within easy reach. A landsman at sea for the first time can form no correct estimate of dis- 1 tance. The same is true of a person accustomed to live in a hilly or mountainous section when he first visits a prairie country. The judg¬ ment of distance is formed partly by the combined use of the two eyes, — one serving as a means of correcting the other, — by the amount of muscular effort required to accommodate the eye to see the objects clearly, and by the relative size of objects with which we are familiar. For instance, we are familiar with the size of a man or a horse ; if we see a man or a horse some distance away, we judge some¬ thing of the distance by the apparent size. If we were to look through a reversed telescope, which makes everything look small, we should have the same impression, that of a person a long distance oft', even though he might be very close by. The advantage of using both eyes in judging of distance is well appreciated by one who at¬ tempts to thread a needle with one eye closed. We are aided in judging of the size of an object by a knowledge of its distance. We can form no notion of the size of the moon, be¬ cause we can form no visual estimate of its distance, and rice versa. Judgment of Solidity.— W e are enabled to form an opinion re¬ specting the solidity of an object by two means ; first, by means of the lights and shades of its surface, and second, by the conjoined use of the two eyes, which enable us to see more than half of a sphere, owing to the difference in position of the two eyes. It is thus evident that we do not form opinions respecting objects exactly as we see them, but as the impressions of sight are corrected by comparison with each other and with the impressions received through the other senses. Curious Facts about the Sense of Sight. — There are many curious facts about sight well worth mentioning, only a few of which we have room to consider. First we may mention that although every one is familiar with the fact that color as well as simple light may be appreciated by the eye, no explanation has yet been foimd for the power to distinguish color. The color of objects is due to the fact AFTER-IMAGES. 191 that light is compound, and that some objects have the power to ab¬ sorb some portions of the constituent elements of light and reflect others, the elements reflected determining the color. For example, an object reflecting red rays only, is red ; one reflecting blue only, is blue, etc. It was. formerly supposed that red, yellow, and blue were the primary colors, or color sensations ; but an eminent scientist has re¬ cently shown that the old view is incorrect, and that the primary color sensations are red, green, and violet, When all three of these colors fall upon the retina at once, white or colorless light is produced. By their combination in various proportions all other color sensations may be produced. White may also be produced by combining the following colors : red and blue-green ; orange and blue : vellow and indigo-blue ; green-yellow and violet ; purple and green. After-Images. — After looking at a bright object, as the sun, for a few seconds, and then closing the eyes, the image formed on the retina will persist for some time. The same phenomenon may be noticed in the morning when the retina is rested. If upon first waking a person looks at the window, he may, upon closing his eyes, still retain the image with all the distinctness with which the objects viewed were seen when the eyes were open, the same form, color, and other visual properties being accurately preserved. Such images as these are known as posi¬ tive after-images. A more usual form of after-image is that which is produced by looking upon a white ground after the eye has been for some time steadfastly fixed upon some dark cr colored object. If a per¬ son has been looking at a white spot upon a dark ground, upon looking at a white ground, as the wall, he will see a dark spot of the same size and form as the light spot. When tire spot is of a red color, the image seen on the white ground will be greenish-blue, which is the comple¬ ment of red. Orange produces blue ; green, pink ; yellow, blue ; etc. The explanation is that the part of the retina upon which the im¬ age of the object is formed becomes weary with receiving the particular sensation, and consequently while the rest of the retina which is fresh receives a sensation corresponding to the color of the object viewed, the tired spot responds to but a part of the rays, and so shows a different color, really making a physiological decomposition of the rays of light. Images of this sort are called negative. The Blind Spot. — The portion of the retina which possesses most acute vision is the visual center, which is a little to one side of the point at which the optic nerve enters the eye. The point of entrance of the 192 ANATOMY, PHYSIOLOGY, AND HYGIENE. optic nerve is wholly insensitive to visual impressions, as there are at this point none of the terminal elements of the optic nerve, which alone possess the power of receiving impressions. The existence of this insen¬ sitive portion of the retina, commonly termed “ the blind spot,” can be easily shown by a simple experiment with Fig. 87. Holding the book Fig-. 87. squarely before the face and so that the figure will be on a level with the eyes, place the hand over the left eye, and with the right eye look steadily at the small cross at the left end of the figure. Now place the book at a distance of about four inches from the eye. Both the cross and the round white spot will be distinctly visible ; but as the book is moved from the face the white spot will disappear at a distance of six to eight inches. With a little care any one can perform the experiment. Another way of showing the same fact without the figure is this : Pin two cards upon the wad about two feet apart, and on a level with the eyes. Now close the left eye and look at the left card with the right eye, or vice versa. Both cards will be visible, the right one indistinctly, of course. Keeping the right eye fixed upon the left card, walk backward. At a distance of six to eiirlit feet from the cards the rinht one will o 0 vanish. Contrast. — A white stripe placed between two black stripes looks much whiter at its edges than in the middle, which may even look a little dull in contrast with the edges, though the color is uniform. A small sheet of gray paper placed in the middle of a larger sheet of green paper and covered with a sheet of thin tissue paper, appears of a pink color, which is complementary to green. TEE LAW OF USE AND ABUSE. 193 HYGIENE OF THE SPECIAL SENSES, The Law of L se and Abuse. — Sensation is clue to change of state. O If the external agents which make impressions upon our organs of sense remained always in the same relation to them, we should possess sensi¬ bility or sensation but a very brief space of time. Our sensations arise from the constant changes in the relations of surrounding objects to our organs of sense. For example, an object laid upon the hand resting upon a table is at first appreciated by the sense of weight or pressure. The first moment of contact the most intense sensation is experienced; after this the impression gradually diminishes, until finally the object is no longer felt at all unless the hand is moved. If the hand be placed in water which the sense of temperature at first appreciates as warm, it very soon loses the sensation of contact with water altogether unless the hand is stirred. Flavors at first very marked, when the sapid substance is held some time in the mouth become less intense. The most sensitive nose may become so accustomed to foul odors that it can no longer ap¬ preciate them. This is experienced by every person who leaves a close room for a few minutes and walks in the pure air. Upon returning, the close, fusty air is almost intolerable; but in a few minutes it is no longer noticed. Loud sounds are no longer heard by ears constantly accus¬ tomed to them unless they are varied, or the attention is especially called to them. An object continually gazed at finally disappears from view. Thus all sensation depends upon constant change of state. From this fact we may deduce the general law relating alike to all the senses, that frequent change is essential. Too long use of any of the senses in any particular way should be avoided, as by this means their sen¬ sibility is blunted. Evils of Excessive Stimulation of the Senses. — Excessive stim¬ ulation of any sense is felt as pain, when extreme in degree. A sensa¬ tion of warmth is pleasurable, but neither extreme cold nor extreme heat is felt as intense heat or cold, but as pain. Very loud sounds, as the noise of an explosion, are avoided as painful to the ear. Moderate light is grateful to the eye, but an intense light, as that of the sun, causes pain. Pain is a faithful sentinel of danger; and so, as might be supposed, these intense stimulations of the nerves of sense are harmful, and should always be avoided when possible. When experienced, they 13 194 ANATOMY, PHYSIOLOGY , AND HYGIENE. rapidly deteriorate the sensitiveness of the organ involved. A tongue accustomed to the strong flavors of highly seasoned food, ceases to ap¬ preciate the delicate flavors which naturally pertain to most articles of diet in a less artificial condition. Hence the evil of condiments. Smoking, tobacco-chewing, tea-tasting, and the excessive use of tea and coffee, as well as the use of strong alcoholic liquors, deteriorate and often almost wholly obliterate the sense of taste. The sense of smell is often entirely lost in consequence of the vile habit of snuff-taking. The habit sometimes acquired by smokers, of expelling tobacco smoke through the nose, ruins the delicate sense of smell. The nerves of this sense, being more slightly protected than any other, are very easily injured. Nasal catarrh also obliterates the sense of smell in many cases. When we consider the great importance of most of the special senses, and the great value of all, it is indeed surprising that so little pains is taken to preserve them. Too often their value is not appre¬ ciated until they have been ruthlessly squandered by careless habits, and are in many cases irrecoverable. On account of their great im¬ portance, we shall devote a little space to the special consideration of the senses of sight and hearing. HYGIENE OF THE EYE. Being one of the most delicate of all the organs of sense, the eye is exceedingly liable to injury by improper use or exposure. Dr. Ed¬ ward G. Loring, an eminent oculist of New York City, makes the folio whig excellent remarks on this subject : — Common Neglect of the Eye. — “Whatever an ounce of preven¬ tion may be to other members of the body, it certainly is worth many pounds of cure to the eye. Like a chronometer watch, this delicate organ will stand almost any amount of use, but when once thrown off its balance, it can very rarely be brought back to its original per¬ fection of action, or, if it is, it becomes ever after liable to a return of disability of function or the seat of actual disease. One would have supposed from this fact, and from the fact that modern civilization has imposed upon the eye an ever-increasing amount of strain, both as to the actual quantity of work done and the constantly increasing brilliancy and duration of the illumination under which it is per¬ formed, that the greatest pains would have been exercised in main¬ taining the organ in a condition of health, and the greatest care and TOBACCO A CAUSE OF EYE DISEASE. 195 solicitude used in its treatment when diseased. And yet it is safe to say that there is no other organ in the body the welfare of which is so persistently neglected as the eye. “ I have known fond and doting mothers to take their children of four or five years of age to have their first teeth filled, instead of hav¬ ing them extracted, so that the jaw might not suffer in its due devel¬ opment, and become in later years contracted ; while the eye, the most intellectual, the most apprehensive, and the most discriminating of all our organs, receives not even a passing thought, much less an exam¬ ination. It never seems to occur to the parents that the principal agent in a child’s education is the eye ; that through it it gains not only its sense of the methods and ways of existence of others, but even the means for the maintenance of its own ; nor does it occur to the parents for an instant that many of the mental as well as bod¬ ily attributes of a growing child are fashioned, even if they are not created, by the condition of the eye alone. “ A child is put to school without the slightest inquiry on the part of the parent, and much less on the part of a teacher, whether it sees objects sharply and well defined, or indistinctly and distorted ; whether it be near-sighted or far-sighted; whether it sees with one or two eyes ; or finally, if it does see clearly and distinctly, whether it is not using a quantity of nervous force sufficient after a time not only to exhaust the energy of the visual organ, but of the nervous system at large.” O Tobacco a Cause of Eye Disease. — The numerous observations on the subject leave no room to doubt that the use of tobacco is a po¬ tent cause of disease of the eye. In fact, instances of nearly every functional disease of the eye have been traced to the use of this power¬ ful poison. Amaurosis, and total blindness from degeneration of the optic nerve, have also been traced to this cause. Recent observations point to tobacco and alcohol as the great causes of color-blindness, or Daltonism, which accounts for the fact that it is very much more com¬ mon in men than in women. Effects of Poor Light. — The use of poor light, and especially the improper construction of school-rooms in relation to light, is a most potent cause of diseases of the eye. Careful examinations of large numbers of students in all grades have shown that defects of sight in¬ crease in a rapid ratio from the lowest grades to the highest, students in the higher classes in colleges and universities suffering to a most astonishing and alarming extent. 196 ANATOMY, PHYSIOLOGY, AND HYGIENE. Attention should be given to the eyesight of children at an early age, and especially before they are sent to school, or before a profes¬ sion or trade is chosen for them. If the sight is found to be weak or otherwise defective, they should not be compelled to close confine¬ ment with books, and should be put to learn some trade or engage in some business which will not require close attention of the eye. An eminent New York oculist has recently urged the enactment of a law requiring that all children be submitted to an examination of the eyes before being granted admission to the public schools. If this plan should be adopted, no doubt many cases of disease of the eye which become serious by neglect, might be cured by the early discovery which would be thus made. A Cause of Near-Sightedness. — One of the recognized causes of near-sightedness is looking at near objects for too long a time with¬ out relieving the eye. The optical apparatus is, by a curious mechan¬ ism provided by nature, constantly adapted to the varying distances at which objects are viewed when the eyes are being employed in look¬ ing about at various objects. If near objects are looked at too long a time, the result will be that the particular adjustment for short dis¬ tances will become a more or less permanent condition. It is in this way that watch-makers, microscopists, proof-readers, compositors, writers, book-keepers, and especially students, are so liable to this disease of the eye. It should be recognized that a near-sighted eye is really a diseased eye. The idea held by many persons that an eye which has this peculiarity is an uncommonly strong one is an error. Short-sight is an evidence of weakness and disease rather than of strength. O The following very sensible remarks referring to the prevention of this defect in school-children we quote from the Educational Weekly : — “ Encourage the pupil to look off* the book frequently, to change the focus of sight by regarding some distant object. It is not enough to look around vaguely ; the eye must be directed to something which is to be clearly seen, like a picture or a motto upon the wall, or a bit of decoration. The greatest damage to the eyes of students is the protracted effort to focus the printed page. It was simply barbarous, the way we used to be “ waked ” in school, when we looked off the book. It is easy for a teacher to know the difference between the resting of the eye and the idle gazing around that cannot be allowed. IiULES FOR PRESERVING THE EYE-SIGIIT. 197 I regard this as most important, and the disregard of it as most pro¬ lific of trouble.” The following excellent rules for preserving the health of the eyes have been chiefly compiled from the best authorities on the subject : — 1. Never use the eyes when they are tired or painful, nor with an insufficient or a dazzling light. Lamps should be shaded. 2. The light should fall upon the object viewed from over the left shoulder, if possible ; it should never come from in front. 3. The room should be moderately cool, and the feet should be warm. There should be nothing tight about the neck. 4. Hold the object squarely before the eyes, and at just the proper distance. Holding it too near produces near-sightedness. Fifteen inches is the usual distance. 5. Never read on the cars, when riding in a wagon or street-car, nor when lying down. Serious disease is produced by these practices. G. Do not use the eyes for any delicate work, reading, or writing, by lamp-light, before breakfast. 7. Avoid much use of the eyes in reading when just recovering from illness. 8. Never play tricks with the eyes, as squinting or rolling them. 9. If the eyes are near-sighted or far-sighted, procure proper glasses at once. If common print must be held nearer than fifteen inches to the eye for distinct vision, the person is near-sighted. If it is required to be held two or three feet from the eye for clear sight, the person is far-sighted. 10. A near-sighted person should not read with the glasses which en¬ able him to see distant objects clearly. A person who has long sight should not attempt to see at a distance with the glasses which enable him to read. 11. Colored glasses (blue are the best) may be worn when the eye is pained by snow or sunlight, or by a dazzling fire or lamp light. Avoid their continued use. 12. Never patronize traveling venders of spectacles. 13. Rest the eyes at short intervals when severely taxing them, ex¬ ercising the lungs vigorously at the same time. Tired eyes may often be refreshed by bathing in cool water, or water as hot as can be borne. 14. Avoid sudden exposure of the eye to a bright light, as when first waking from sleep. Study by lamp-light before breakfast is par¬ ticularly injurious on this account. 198 ANATOMY , PHYSIOLOGY, AND HYGIENE. 15. Defective ventilation, unequal heating, — causing cold feet and congestion of the head, — and had food, causing impure and impoverished blood, are serious causes of diseases of the eye. 16. Popular eye-washes, and various ointments, salves, etc., prepared according to popular recipes, or sold by quacks, should never be used. 17. Upon the discovery of any defect in the sight, consult a compe¬ tent physician (not a traveling quack) at once, as serious disease may be saved by timely advice or treatment. HYGIENE OF THE EARS. The number of people who suffer with defects of hearing in greater or less degree is almost if not quite as great as those who suffer with defective eyesight. The ears are neglected as much as the eyes ; but, fortunately, slight impairment of hearing is not accompanied by any¬ thing like so great inconvenience or loss as an equal degree of impair¬ ment of vision. From inattention, neglect, and abuse, the ears become seriously or hopelessly diseased, when a little timely attention or warn¬ ing might have saved them. It should be mentioned in this connection that diseases of the ear are to be avoided not only on their own ac¬ count, but on account of the fact that owing to the close proximity of the organ to the brain, and its intimate connection with the bones of the skull, serious and even fatal disease not infrequently results from affections of this organ. We will call attention to some of the most important points connected with the hygiene of the ear. Danger of Meddling with the Ears. — The common habit of picking at the ears to remove the wax or cerumen which accumulates in them, is very injurious. Especially bad is the use of ear-picks or spoons. Boring out the ear with the twisted corner of a towel is a most absurd as well as injurious practice, since it not only does not remove more than a very small portion of wax, but crowds the balance down into the bottom of the canal, against the delicate membrane of the drum. Ex¬ cept in cases of disease, ear-wax seldom requires removal, as nature has provided for this. When the ears are let alone, as they should be, the wax dries and scales off in thin flakes, which drop from the ear sponta¬ neously. It is only in cases of disease that the wax accumulates to such an extent as to be detrimental. If there is itching of the ears, it is a sign of disease ; and the more they are irritated by picking or cleaning, the worse the evil will become. The more assiduous the attempts to keep the ears free from wax, the greater will be the accumulation, as DANGER OF BOXING THE EARS. 199 the secretion is increased by the mechanical irritation. Well-mean¬ ing mothers often do their children a great amount of harm by at¬ tempts to keep their ears free from what nature designed as a protec¬ tion. The protest which children always make to having their ears bored out with towels and scrubbed with soap and water inside as well as outside, is a perfectly natural and entirely proper resentment of the outrage. The outer parts of the ear may very properly be washed as often as desired, provided they are always wiped dry ; but nothing should ever be introduced into the canal of the ear unless made nec¬ essary by disease or accident. Putting things in the ear is a practice sometimes acquired by chil¬ dren, and often irreparable injury is thereby done. Children should be carefully watched, and early taught to let the ear alone. Beans, kernels •f rice, wheat, and corn, and a great variety of small objects, have been removed from the ears of children by surgeons to whom they have been taken for treatment for deafness. Inflammation is not infrequently set up by this means, which may occasion permanent loss of hearing. Throwing at each other wheat, sand, and other small objects, should be strictly forbidden children, and should never be practiced by any one. We recently met a gentleman whose hearing in one ear was wholly de¬ stroyed when a child by having lodged in his ear a kernel of wheat from a handful thrown at him by a playmate. It was never extracted, and the inflammation excited caused a permanent loss of hearing. Danger of Boxing the Ears. — The common practice of cuffing the ears is not only cruel but dangerous. The violent forcing of air into the ear in this manner has oftencaused rupture of the delicate drum mem¬ brane. Sometimes serious inflammation is occasioned; and in one case which we have in mind a child died from the effects of a cufl upon the ear received at school. Both parents and teachers often box or cuff the ears of children for inattention, when it will be found in a large num¬ ber of cases in which a child is apparently inattentive that the difficulty is hardness of hearing, which will of course be made worse instead of being remedied by the punishment inflicted. It should be understood and remembered that the hearing of children is often temporarily im¬ paired by various causes, particularly by colds and attacks of “earache, and also that in some forms of deafness a person may be quite hard of hearing when not expecting to be spoken to and hence not giving at¬ tention, and yet hear very well when listening. Before a child who seems to be habitually inattentive is punished for the supposed fault, liis 200 ANATOMY, PHYSIOLOGY, AND HYGIENE. cars should both be carefully tested by trying each one alone with a watch, or by speaking in a moderate tone of voice at different distances. Taking Cold in the Ears. — The form of ear disease known as throat deafness is that in which the impairment of hearing is really due to disease of the throat, which is most commonly caused by taking cold. The thickness of hearing due to a common cold in the head is occasioned by the thickening of the mucous membrane about the openings of the Eustachian tubes in the throat. This usually passes away in a short time; but in cases of catarrh, especially post-nasal and pharyngeal catarrh, the condition may become permanent ; am] the local disease may extend up into the canal and even to the ear itself, occasioning very great in¬ jury to the ear. It ought to be generally known, too, that the very common affection called earache is really a matter of quite serious character, being inflam¬ mation of the middle ear, or drum of the ear. Treatment should be prompt, and care should be taken to prevent recurrences, as the hearing may be thereby permanently injured. Full directions for treatment are given in the proper place. Exposures of the Ears. — Both extremes should be avoided in the case of the ears. Too much protection makes them delicate and easily disturbed by the occasional exposures to which they must be subjected. It i§ probably for this reason that women are more liable than men to suffer with acute inflammation of the ear, as has been observed by some aurists. People who always have their ears covered or pro¬ tected by plugs of cotton, are quite sure to be always troubled with their ears. The ears should be accustomed to exposure, and only pro¬ tected when subjected to some unusual exposure, as when riding a long distance in a cold wind. The use of cotton in the ears is at¬ tended by some risk, being often productive of harm, as cotton placed in the ear is not infrequently forgotten, being left in place, and even pushed farther into the ear by successive plugs. As many as three pellets of cotton which had been successively inserted in this way have been removed by an aural surgeon. When thus retained, wax accumulates about the cotton, and thus may occasion mechanical ob¬ struction to hearing, and serious inflammation. Cold water should never be introduced into the ear. When in¬ jected with a syringe, and even when poured in, it causes giddiness, and may give rise to inflammation. Boys often cause an inflamma¬ tion of the ear by “going in swimming” or ducking the head in wa- EXPOSURE OF THE EARS. 201 ter. By submergence of the head the external canals are filled with water, which is usually of a temperature lower than that of the blood, which causes congestion and may occasion inflammation. Early deaf¬ ness is often produced in this way. Those who own dogs which are accustomed to go into the water much, or are often thrown in, fre¬ quently find that they become deaf in consequence. Wetting of the hair is a cause of injury to the ear, as well as wet¬ ting the ear itself. The practice is especially harmful in cold weather. Care should be taken to dry the hair, especially near the ears, when¬ ever it is wet. It is well to protect the ear from loud sounds, which are especially liable to cause injury if unexpected. When anticipated, the drum membrane is prepared by the action of muscles for the purpose, so that injury is less likely to occur. Persons have been made stone deaf by confinement in a belfry during the ringing of a large bell. Artillery-men often lose their hearing in consequence of the loud noises to which their vocation exposes their ears. Even shouting loudly in the ear has been known to produce injury. A bit of cotton placed in the ear will do much to deaden sound. One other caution should be given in conclusion. The attempt is sometimes made to relieve toothache by placing in the ear cotton sat¬ urated with camphor, chloroform, or other medicaments. While this mode of treatment is sometimes successful, the plan is not a good one nevertheless, as the injury done to the ear may be greater than the benefit received by the tooth. Both the tooth and the ear should be treated on their own merits, each for its own maladies, unless the other be implicated as a cause. Full explanations respecting the use of ear-trumpets and other means of aiding impaired hearing are given in connection with the consideration of the subject of deafness. 202 ANATOMY, PHYSIOLOGY, AND HYGIENE. THE CIRCULATORY APPARATUS. The organs of circulation, or the circulatory apparatus, constitute the means by which the blood, the nutritive fluid of the body, is cir¬ culated through all its different parts, carrying new material to parts requiring it for repairs, and carry¬ ing away to be ex¬ pelled from the body worn-out and useless or clogging elements DO O wherever found. The circulatory apparatus consists of the heart, the blood-vessels, and the lymphatics, the structure and func¬ tions of which we will now briefly ex¬ amine. The Heart.— Fig. 88. The heart is the central organ of the circulation, and hence is very properly placed near the center Fig’. S8. The Heart. 1. Hight Auricle; 18. Left Auricle; ^^dy, in tile 2. Vena Cava; 3. Aorta; 4. Pulmonary Veins; 5. Coronary Arte- thorax its exact posi- ry and Veins; 6. Pulmonary Artery. _ ’ _ * tion being a little to the left of the median line in the central part of the chest, between the two lungs. The heart is a muscular organ. It is, in fact, a hollow muscle. It is conical in shape, and is suspended in the chest, with the base upward and the apex downward. The apex is free, and when the heart is beating may be felt to strike the chest just below the fifth rib Plate V. THE CIRCULATION. VALVES OF THE HEART. 203 and about one and one-half inches to the left of the breast-bone. The weight of the heart is ten to twelve ounces in men, and eight to ten in women. The heart is really a double or¬ gan, and may properly be considered as two hearts joined together. See Fig. 89. In some lower animals the two hearts are separate. See Fig. 90. The two hearts are called, re¬ spectively, the right heart and the left heart. Each heart has two cavities, a lower, called the ventricle, and an upper, called the au- Fig. 89. Diagram showing the two sides of the Heart and ride, On aCCOUllt of its their cavities. ear-like appearance. The walls of the left ventricle, or the lower cavity of the left heart, are very much thicker than those of the right ventricle. A diagram of the cavities is shown in Fig. 89. Valves of the Heart.— The auricle and the ventricle of each heart communicate with each other, but there is no direct communica¬ tion between the two hearts except in the infant before and just after birth when there is an opening between the two auri¬ cles. This opening between the auricle and ventricle in each heart is guarded by a valve which allows the blood to pass from the auricle into the ventricle but not back into the auricle. The valve in the left heart is called the mitral or bi-cuspid, having two cusps, or curtains. The valve in the right heart, having three cusps, is Called the tri-CUSpid valve. See Fig. 91. Fig. 90. The Double Heart of Each of the cavities of the two hearts tL' Dus°ns' communicates with blood-vessels, the auricles communicating with 204 ANATOMY , PHYSIOLOGY , v!2VrD HYGIENE. Figr. 91. The Heart with portions of its walls removed, show¬ ing interior of cavities. 6, Try Cuspid Valve; 10. Mitral Valve; 12. Semi-Lunar Valve. Figr. 92. Section of the Heart, showing rela¬ tive size of its cavities, and thickness of the walls of the ventricles. veins, and the ven¬ tricles with arteries. The openings between the ventricles and ar¬ teries are also guarded with valves upon both sides, which from their half-moon shape are termed semi¬ lunar valves. The left semi-lunar valve guards the opening between the left ven¬ tricle and the aorta. The right semi-lunar valve guards the opening between the rie'ht ventricle and o the pulmonary ar¬ tery. The veins have no true valves at their openings into the au¬ ricles, but are slightly constricted. The Pericardium* — The heart is contained in a delicate sac called the heart-case, or pericar¬ dium, the lining membrane of which secretes a fine lubricating fluid to secure the utmost ease of action. The heart is lined with a delicate membrane, the endo¬ cardium, which is continuous with the lining of the blood-ves¬ sels. The Blood -Vessels. —There are three classes of blood-ves¬ sels, — arteries, capillaries, and veins. The arteries differ from the veins in having rigid walls, THE PRINCIPAL ARTERIES. 205 ■\\ hich are in the large arteries chiefly composed of connective tissue, but in the smaller ones contain a large proportion of involuntary muscular tissue. The smallest arteries, called arterioles, have their walls almost wholly made up of muscular tissue. The arteries derive their name from the fact that they are found empty after death, which led the ancients to suppose they were simply ducts for air. Fig. 93 gives a general view of the arterial sys¬ tem. Names of Some of the Principal Arteries. — The following are the names of some of the principal arte¬ ries of the body : — The aorta is the great artery of the body. It starts at the left ven¬ tricle, and subdivides into numerous branches in the various parts of the body through which it passes. Arch¬ ing upward as it leaves the heart, the aorta sends off large branches which supply blood to the head and upper extremities. The chief of these are the innominate, the carotid, and the subclavian. The first two sup¬ ply the right arm and the head, and the third the left arm. In the arms the arteries become first the brachial, which divides in the fore-arm into the ulna and radial, the ends of which unite in the hand to form an arch in the palm, known as the palmar arch. As it passes downward through the chest, the aorta gives off branches to the lungs and other organs contained in the thorax. In the abdominal cavity, branches are given off to the abdominal organs, the stomach, pancreas, spleen, intestines, liver, kidneys, and other viscera. In the pelvis the aorta divides into two branches, one of which goes to each of the inferior extremities, the plan of distribution in the lower limbs being similar to that in the arms. The large pulmonary artery which leaves the right ventricle is distributed wholly to the lungs. The Arterial System. 206 ANATOMY , TIIYSIOLOGY, AND HYGIENE. The Capillaries. — These are the smallest of the blood-vessels. They are so very small that they can only be seen with a good micro¬ scope. Their walls consist only of the lining membrane of the arte¬ ries. They form an intricate mesh work through all the soft tissues of the body. The size of the capillaries is generally not more than of an inch, and some¬ times less. The Yeins. — The veins begun with the capillaries, and gradually increase in size as they approach the heart, by the joining together of branches from different parts of the body. The veins differ from the arteries, 1. In being more numerous, there usually being two veins for one artery ; 2. In having flaccid walls which collapse when they are not filled ; 3. In having little or no muscular fibre in their walls, so that they cannot con¬ tract as do the arteries ; 4. In having valves in some parts of the body which allow the passage of blood in only one direction, — toward the heart ; 5. In com¬ municating freely with each other by connecting branches. The location of the valves can be readily seen by tying a cord around the arm, thus interrupting the flow of blood. In a few seconds the veins of the hand and arm will be very much swollen with blood, and at regular intervals along the vein, about an inch apart, will be noticed little prominences which mark the location of valves. Fig. 94 gives a general view of the Venous System. The valves are well shown in Figs. 95 and 96. The veins usually correspond in name to the arteries which they accompany. A few of the most important are, the ascending and de¬ scending venal cavce, which gather all the blood from the veins of the upper and lower parts of the body respectively; the innominate, which collects the blood from the head and upper extremities ; the jugular, which returns blood toward the heart from the brain and Fig:. 94. The Venous System. ACTION OF THE HEAET. 207 head ; the portal vein, -which collects the blood from the stomach, pancreas, spleen, and intestines, and conveys it to the liver ; the hepatic vein, which conveys blood from the liver to the as¬ cending vena cava; and the four pulmonary veins, which convey the blood from the lungs to the left auricle of the heart. For a representation of the system of blood-vessels, see Fig. 93. Action of the Heart. — Like all other muscles, the function of the heart is to contract. In do¬ ing so it expels from its cavities the blood con¬ tained in them, just as water is pressed out of the rubber bulb of a syringe. Each portion of the heart goes through a rhythmical action of contraction and dilatation, the two hearts, or right and left side of the heart, if it be considered as one, acting together. The auricles, contracting, send the blood which they contain through the mitral and tri-cuspid valves into the ventricles. When the ventricles contract, they send their blood through openings guarded by the semi-lunar valves into the aorta and pulmonary artery. This action is shown in Figs. 97 and 98. %ig. 95. Fig-. 96. Fig. 95. Valves of veins closed. Fig. 96. Valves of veins as thev appear « hen a vein is slit open. This action of the heart occurs about seventy-two times a minute, or four times for each respiration, and is called the heart-beat. Heart Sounds. — The beating of the heart is accompanied by two sounds, the first of which is produced by the striking of the apex of the heart against the wall of the chest, by the muscular con¬ traction of the heart, and by the closing of the valves between the auricles and the ventricles. The second sound is a short click made by the semi-lunar valves as they close together after the blood has been forced from the ventricles Fitr. 97. Diagram showing Valve between Auricle and Ventricle open, ana Semi-lunar Valve closed, allowing the Ventricle to fill. into the arteries, to prevent its return into the heart. 208 AX ATOMY, PHYSIOLOGY, AND HYGIENE. Amount of Work Done by the Heart. — Various estimates have been made of the force exerted by the heart in driving the blood through the arteries. Recently it has been shown very conclu¬ sively that the left ventricle exerts a force of no less than fifty pounds in its contraction, that of the right ventricle being only about one-third as much, and the auri¬ cles about one-tenth as great. Adding together the force ex- erted by the different portions of the heart at each beat, we have an aggregate of over seventy-five pounds. By this is meant that the heart exerts, each time it beats, a force as great as would be re¬ quired to lift seventy-five pounds a foot high. To ascertain the amount of work done by the heart, then, we have only to mul¬ tiply the amount of work done at each beat by the number of Fig. 98. Diagram showing Valve between , . . . Auricle and Ventricle closed, and Semi-lunar beats in a given time. Hie aver- alve open, allowing blood to pass into the Arte- ao-e jg seventy-two beats a ries. J , minute, which would be 4,320 an hour, and 103,680- in a day of twenty-four hours. Multiplying the last amount by seventy-five, gives us 7,77 6,000 pounds as the entire work done by the heart during one day, which is equivalent to lifting 3,888 tons a foot high in a minute. This amount seems so enor¬ mous as to be almost incredible ; but there is no doubt of the correct¬ ness of the estimate. The wonderful vitality of the heart is shown not only by the amount of work done by it, but by the remarkable tenacity of life which it manifests, continuing to work under the most embarrassing circum¬ stances, as in disease, and when other important parts of the body have ceased to act. In cold-blooded animals it will even continue its rhythmical contractions for hours after the animal is killed and the heart taken from the body. The heart of a turtle can be made to con¬ tract more than twenty-four hours after being removed from the body of the animal. Although the heart seems to be in such constant activity, some FREQUENCY OF THE PULSE. 209 part of it is always at rest, each acting part taking a short rest after each contraction before acting again. The heart in this way obtains nine or ten hours of rest out of each twenty-four. The Pulse. — When the heart contracts, a wave-like impulse is sent throughout the whole arterial system, traveling from the heart to the remotest part of the body in about the sixth part of a second, so that it is practically instantaneous. Where the arteries come near the sur¬ face, this impulse may be felt, and is called the pulse. The most con¬ venient place for feeling the pulse is in the radial artery just above the wrist, on the outer or thumb side of the arm. It may also be felt in the carotid artery of the neck, the temporal artery of the temple, and in many other localities. Fig:. 99. Tracing of the pnlse obtained by the sphygmograph. An ingenious instrument known as the sphygmograph, the use of which is described elsewhere, has been invented within a few years, by which the character of the pulse may be more carefully studied than with the finger. The tracing shown by the white line in Fig. 99 we obtained with one of the latest and most improved forms of the instrument, known as Pond’s Sphygmograph, a cut of which is shown elsewhere. As the pulse is really an index to the condition of the heart, it becomes also a good indicator of the general condition of the system, and much valuable information can be gained from its careful study. The various indications of the pulse are given elsewhere. Frequency of the Pulse, — The pulse, of course, corresponds ex¬ actly with the heart-beat in frequency, and whatever modifies one af¬ fects the other as well. The usual average rapidity is about seventy- two beats a minute. This rate is very considerably modified by vari¬ ous influences, some of which may be mentioned with advantage. 1. The frequency of the pulse greatly depends upon the age. At birth the pulse rate is 136 ; from two to seven years, 97 ; fourteen to twenty-one, 76; twenty-eight to thirty-five, 70; fifty-six to sixty- three, 68 ; seventy-seven to eighty-four, 71. In females the pulse is seven to ten beats faster than in males. The average rate of pulsa¬ tion in males, from two to eighty years, is 73 ; that of females is 82. 14 210 ANATOMY, PHYSIOLOGY, AND HYGIENE. 2. Posture modifies the pulse rate. For example, it has been found that the pulse of a person whose heart beats 66 times a minute while lying’ down will be about 71 J o when sitting, and 81 when standing. 8. The frequency of the pulse is affected by temperament. In some persons the pulse is naturally much more rapid than in others. Some persons have remarkably slow pulses. Both Napoleon and Welling¬ ton had pulses remarkable for their slow¬ ness, not averaging more than fifty beats a minute. We once met a case, that of a young lady, in which the pulse was but thirty-two ; another patient, a young man who was in a very debilitated condition, we found with a pulse of but thirty. 4. Digestion increases the heart-beat from five to ten per minute. The increase in frequency of the pulse is particularly marked after a meal consisting largely of flesh food. o. The influence of exercise upon the heart’s action is very great. A person whose pulse is 68, after a slow walk will have a pulse of 78; after walking at the rate of four miles an hour, 100; and after a rapid run, 140 to 150. In children and women the pulse is considerably slower during sleep than when simply reclining while awake. In adult males there seems to be no difference. 6. The heart’s action is greatly ac¬ celerated by a high temperature, and is retarded by cold. A Turkish or Russian bath or a warm full bath will occasion a very considerable increase in the activity of the heart. The pulse of persons living in warm climates averages greater than that of those liv¬ Fig-. lOO. A Diagram of the Cir¬ culation. 1. Left Ventricle ; 2. Right Ventricle; 3. Liver; 4. Spleen; 5. In¬ testines; 6. Stomach; 7. Pancreas; 9. Urinary and Sexual Organs; a. Aorta ; r r. Lungs ; a. Pulmonary Ar¬ teries; V. Pulmonary Veins. ing in cold climates. O THE SYSTEMIC CIRCULATION. 211 A curious account is given by physiologists of a man who possessed such control of his heart as to be able to suspend its action altogether. On one occasion he remained for half an hour appearing as though dead, neither respiration nor heart action being perceptible. Several medical men were present. The Course of the Blood in the Circulation. — The circulatory apparatus of the system may be divided into three distinct circulatory sys¬ tems; viz., the general or systemic, the pulmonary, and the portal. These three systems and their relations to each other and to the heart are shown in Figs. 100 and 101, and still better in the diagram on Plate V. The general course of each of these three systems we will now trace. The Systemic Circula¬ tion. — The circuit of blood for the body in general starts at the left ventricle of the heart. By the contraction of the heart the blood is forced into the aorta, and as the semi-lunar valves close tightly behind it, each succeeding contraction forces the blood far¬ ther on in the arteries until it is thus propelled to the minute capillaries of the whole body. In these the blood flows very slowly, the motion often being imperceptible. The capillaries finally merge into veins, which gradually grow larger in size and smaller in number until they finally all unite to form two great venous trunks, the ascending vena cava, which conveys to the heart all blood from the lower part of the body, and the descending vena cava, which empties into the heart all the blood from the upper part of the body. The two vessels empty their contents into the right auricle. This completes the circle of the Fig:. 101. Diagram of the Circulation, showing by means of arrows t.ie direction of the blood current in the blood-vessels. 212 ANATOMY, PHYSIOLOGY, AND HYGIENE. systemic circulation, which, as will he observed, conveys the blood from the ventricle of the left heart to the auricle of the right heart. Tlie Pulmonary Circulation. — In order to provide for its purifica¬ tion, we have a second s}rstem through which the blood is circulated. In this system the blood which is received into the right auricle from all parts of the body is forced by its contraction into the right ventricle, whence it is forced into the pulmonary arteiy. This artery conveys it to the lungs and distributes it in a special set of capillary vessels in which it undergoes purification, and is then, by means of the pulmonary veins, conveyed back to the heart, which it enters at the left ventricle. It is thus seen that the pulmonary circulation forms a circuit for the blood from the right ventricle of the heart to the left auricle, whence it enters the left ventricle and again begins its round in the systemic circuit. The Portal Circulatiou. — This system is really a subdivision of the systemic circulatory system. The blood which is distributed to the stomach, intestines, pancreas, and spleen, instead of returning with the rest of the blood of the general system direct to the heart by means of veins and the vena cava, is collected from all these organs by a large vein knoAvn as the portal vein, which conveys it to the liver, where it is distributed through a special set of capillaries provided to enable the liver to perform its special functions upon the blood, removing impuri¬ ties, completing the work of digestion to some extent, etc. All the ele¬ ments absorbed by the veins of the stomach during digestion are thus submitted to inspection before being allowed to enter the general circu¬ lation. From the liver the blood is carried to the ascending vena cava by means of the hepatic vein, and thus the portal circulation is com¬ pleted. Forces of the Circulatiou. — The heart, although the chief, is not the only active agent in the circulation of the blood. Several agents have part in the work, the principal of which will be enumerated as follows: — 1. The Heart. — As already seen, the force exerted by the heart amounts to about seventy-five pounds each beat; and although this force is sufficient to propel the blood to the capillaries, so large an amount of friction results from the immense surface over which the blood passes in the capillaries that additional force is required. Again, there is good evidence for believing that the blood will continue to circu¬ late without the action of the heart, the arteries being always found empty when examined after death, though they must have been full FORCES OF THE CIRCULATION. 213 when the heart ceased its activity. In some low animal forms, too, the circulation is carried on without the aid of the heart, just as the sap is circulated in a plant. 2. The Arteries. — The contraction of the heart, which gives the blood a propulsive impulse, is followed up by the contraction of the arteries. The small arteries are supposed to be specially active in assisting the cir¬ culation. Some observers claim that the small arteries or arterioles keep up a constant peristaltic action, by means of which the blood is urged forward. 3. The Capillaries.- — While the capillaries themselves are simply passive agents, the passage of the fluid part of the blood through their walls must occasion a capillary action similar to that which causes the rising and circulation of sap in trees and plants. It is claimed by some physiologists that the circulation is aided by the attraction of the. walls of the capillaries for the nutritive elements of the blood. It is proven, at any rate, that blood which is well oxygenated passes readily through the capillaries, while that which contains carbonic acid is very much re¬ tarded in its progress in this part of the circulation. 4. The Muscles and the Valves of the Veins. — The veins are so placed among the muscles that whenever contraction of the muscles occurs they are compressed, and the blood which they contain is necessarily displaced. As it cannot pass back¬ ward, on account of the valves which close when¬ ever a backward current is established, it must of necessity move forward. Contraction of a mus¬ cle has essentially the same effect upon it that squeezing has upon a sponge filled with water. This is undoubtedly an important aid to the venous circulation. See Tig. 102. 5. Heat. — It is probably true that in certain parts of the body, at least, the elevation of temperature which the blood undergoes in the cap- . diaries aids the circulation by increasing its volume, the pressure of blood from behind compelling expansion in one direction, toward the veins. G. The Lungs. — The lungs operate with considerable force in aiding at least a portion of the venous circulation. When the chest is ex¬ panded, and while it is filling, the pressure being partly removed from the large veins which pass through the chest, the blood rushes in to fill them. In this way much assistance is especially afforded to the circula- Fig\ 102. Diagram showing how the valves of the veins aid the circulation by preventing back current. 214 ANATOMY, PHYSIOLOGY, AND HYGIENE. tion of blood in the liver, which is a wise provision of nature, as it will be observed, by reference to the diagram of the circulation, Plate X, that the blood of the portal system passes through two sets of capilla¬ ries, the double amount of friction thus produced having a strong tend¬ ency to render the circulation in the liver sluggish. Regulation of tlie Circulation. — The heart’s action is under the immediate control of the nervous system. Each beat of the heart is in obedience to an impulse sent to it from the nerve centers of the brain and spinal cord. In order to provide for the various exigencies which make necessary an increase or diminution of the action of the heart, two sots of nerves are provided, one of which accelerates the action of the heart, while the other slows its contractions. The first function is per¬ formed by the s}rmpathetic nerves, the second by the pneumogastric. By the action of these nerves the supply of blood to the general system is regulated according to its wants. For example, when a person is en¬ gaged in active exercise the muscles and nerves demand an increased supply of nourishment, which can only be furnished by an increased supply of blood. The increased waste also demands a quickened circu¬ lation to remove the products of the disintegration due to muscular activity. Hence the pneumogastric nerve releases in part its hold upon the heart, and the sympathetic nerve increases its action. Every part of the body receives an increased supply of blood, those not engaged in active exercise, to some degree at least, as well as those which partici¬ pate in the activity. Regulation of Local Blood Supply. — In addition to the nerves already referred to, there is a set of nerves which accompany the blood¬ vessels in their minutest subdivisions and remotest ramifications, by means of which the circulation of each organ, even each small portion of the body, is controlled. The nerves are connected with a collection of cells in the medulla oblongata known as the vaso-motor center. When an impulse is sent out from this center along any of the nerves which go out from it, the muscular walls of the small arteries to which the nerves are distributed are caused to contract, and thus a less amount of blood is allowed to flow through the part. When a .slight degree of ex¬ citation of the nerves is kept up by the center, the walls of the arteries become relaxed, so that by their dilatation a much larger amount is al¬ lowed to flow through them than before. An experiment often per¬ formed by physiologists well demonstrates this action of the vaso-motor nerves. The vaso-motor nerve of the ear of a white rabbit be km di- O A. "Foot of a frog, slight]}' magnified, B. Tfie heart, showing the origin of the large bipod vessels ; C- Circulation in foot of frog, greatly magnified; V. Red blood corpuscles; E. Blood corpuscles, red and white — a. white, b. red. Prate VI. COMPOSITION OF THE BLOOD. 215 vided, the white skin of the ear quickly becomes red, being congested with blood, the result of paralysis of the small arteries of the part. If the end of the divided nerve be stimulated by electricity, the arteries will at once contract and the skin assume its natural color. Blushing is due to the dilatation of the small arteries of the face from the effect of certain emotions upon the vaso-motor center in the brain. The paleness due to fright and extreme rage results from con¬ traction of the small arteries induced in the same way. The circulation of blood in the stomach, liver, and other internal organs, as well as in all other distinct parts of the body, is controlled by dilatation and contraction of the small arteries, in the manner described. THE BLOOD. The blood is a fluid tissue. In the body there are tissues of all degrees of consistency, from the dense bones and tendons to the per¬ fectly fluid blood. It is a highly vitalized fluid, not a mere chemical solution. The blood contains all the elements necessary for the building up and keeping in repair of all the various tissues of the body. In addi¬ tion to nutritive elements the blood also contains the various effete or waste products which result from the breaking down of the various tis¬ sues as the result of vital action. It not only supplies nourishment to the hungry tissues but washes them free from the noxious products of daily waste. The quantity of the blood has been variously estimated, the esti¬ mates varying from ten to eighteen pounds, or about half as many quarts. Composition of the Blood. — To the unassisted e}'e the blood ap¬ pears to be a homogeneous fluid, of a reddish color which varies from the bright red of the arterial blood to the dark purple blood found in the veins. When examined with a microscope of sufficient power, the blood is found to be made up of about equal quantities of fluid and cer¬ tain minute solid bodies floating in the fluid, called blood corpuscles, of which there are two varieties, white , and red, each of which we will de¬ scribe. White Blood Corpuscles. — The microscope reveals in the blood minute protoplasmic bodies, resembling drops of transparent jelly, which constitute the white blood globules or corpuscles. Plate A I. These minute specks of life may be considered as independent individuals, since 216 ANATOMY, PHYSIOLOGY, AND HYGIENE. they may be removed from the body and kept alive for weeks. A sci¬ entific writer not inaptly calls them little fishes swimming in the life- current which flows through the veins and arteries. So small are these little creatures that twenty-five hundred of them arranged in a row would make a line but an inch in length. When examined closely the white corpuscles may be seen to have in their central portion specks. See minute granular Fig. 103. Red and White Blood Corpuscles. a. White Blood Corpuscle ; b. Red Corpuscle ; c. Red Corpuscle, showing edge; d. Red Corpus¬ cles in rolls, an evidence of health. Fig. 103. The white corpuscles are sup¬ posed to have their origin in the lymphatic glands, in which cor¬ puscles exactly resembling them, and known as lymph corpuscles, are found in great numbers. When carefully studied under various circumstances they are found to undergo a regular proc¬ ess of growth and development like large animals, finally grow¬ ing old and at last dying and being removed from the body, cast out as dead bees are thrust out from a hive by the living workers. While in their active state these remarkable little bodies exhibit many won¬ derful properties. Though they have no organs of locomotion, they are able to move from point to point with ease and considerable rapidity. Having no mouths, they are yet voracious eaters. Though possessing no nerves or organs of any other sort, they appear to be exceedingly sensitive to heat and cold, electricity, and other agencies which in higher forms of life are recognized by organs of sense. How these functions are performed by the white blood corpuscle, — sometimes called the ani¬ malcule of the human blood, — we need not dwell upon in detail here, as the same subject has already been more fully explained in another con¬ nection. * What are known as mucous, lymph, and pus corpuscles are appar¬ ently identical with white corpuscles. The Bed Blood Corpuscles. — Besides the white corpuscles just described, and constituting by far the largest share of the solid con¬ stituents of the blood, are found the red blood corpuscles. See THE BED BLOOD 'CORPUSCLES. 217 Fig. 104. Like the white corpuscles, the red are exceedingly mi¬ nute, from three thousand to thirty-five hundred being required to form a row an inch in length. The red corpuscles differ from the white in several particulars. Instead of being globular, they are bi-concave and disc-like in form, being about one-fourth as thick as broad. Instead of be in" trans- O parent, or gray in color, they are of a faint amber color, the red color of the blood resulting from the massing together of such im¬ mense numbers as are found in the vital fluid. It has been recently determined that there are more than 3,000,000 of these delicate bodies in a drop of blood no larger than can be made to ban" upon the point of a pin. There are no less than 30,000,000,000,- 000 red corpuscles in the whole body. The red are much more numerous than the white cor¬ puscles, in health, the average proportion being about 300 red to one white. The proportion of white corpuscles is greater just after a meal, and in certain forms of disease they occasionally become so numerous as to equal in ■ numbers the red corpuscles, a condition which is very unfavorable to life. The color of the corpuscles is due to a peculiar kind of coloring matter which they contain. By means of this singular substance, as is supposed, the corpuscle acquires the power to absorb many times its own bulk of certain gases, a property similar to that possessed by fresh charcoal, which is rendered a good filtering medium on account of the large amount of condensed oxygen stored up in its pores. The color of the corpuscles differs according to the character of the gas which they are carrying, they being of a bright color when carrying oxygen, and darker when carrying carbonic acid, thus occasioning the difference in color between arterial and venous blood, as will be fur¬ ther explained in treating on the subject of “ Respiration.” The origin of the red corpuscles was for years a puzzle to physiolo¬ gists ; but an ingenious German solved the problem by removing a Fig. 104. Red Blood Corpuscles. 218 ANATOMY, PHYSIOLOGY, AND HYGIENE. small quantity of blood from the body and carefully watching it for a sufficient length of time to witness the actual development of red corpuscles. The blood, by being kept at the temperature of the body and in a moist atmosphere, seemed not to suffer by its removal ; and the patient observer was rewarded for his pains by seeing white blood corpuscles gradually turn into red ones, thus demonstrating that red corpuscles are simply white ones grown old. Each corpuscle acts a part in the body but a brief period, as it passes quite rapidly through its various stages and becomes useless, when it is destroyed and removed from the body. The spleen and liver seem to be the most active blood-destroying organs. The color¬ ing matter of the blood corpuscles after their destruction is converted into the coloring matter of the bile. The blood corpuscles of animals resemble more or less closely those of human beings. Those of the dog are so near like human blood corpuscles as to be scarcely distinguishable. Those of the goat, sheep, and ox, are much smaller, and those of the elephant much larger than those of human beings. The corpuscles of the camel and llama are elliptical in shape, as are also those of birds, reptiles, and fishes. In the three last-named classes of animals the corpuscles are bi-convex instead of bi-concave. The liquid Portion of the Blood. — The liquid half of the blood may be regarded as a solution of albumen, containing also small quan¬ tities of fat, certain salts, waste products, and gases. When exposed to the air the albuminous constituent of the blood is decomposed very quickly, one portion becoming semi-solid. This is what is known as coagulation of the blood. The part which coagu¬ lates is ordinarily known as fibrine. The albuminous elements of the blood are its chief nutritive elements. From these the tissues derive the material from which they are formed. While in solution in the fluid portion of the blood, or 'plasma, they permeate every organ and tissue of the body, thus bathing with a nutritive fluid all the tissues requiring repair. It is a curious fact that the fluidity of these elements seems, in some degree at least, to depend upon their constant motion, for blood soon coagulates when stagnation occurs. Any for¬ eign body introduced into a blood-vessel will also occasion coagula¬ tion. In inflammation and some other conditions the tendency to co¬ agulation is increased. The proportion of fat is ordinarily very small, being not more than FUNCTIONS OF THE BLOOD. 219 one part in twenty-five hundred of blood, or .04 per cent. After a meal consisting largely of fat, a much larger quantity may he found in the blood. In the blood of habitual drunkards, fat is also usually found in greatly increased quantities. The various analyses which have been made for the purpose of de¬ termining the saline constituents of the blood seem to us to be less re¬ liable than would at first appear, since they do not take into account the nature of the individual’s food. We have no doubt that a laro-e O share of the so-called saline constituents of the blood are both unnat¬ ural and unnecessary elements in the quantities in which they are usually found, and that they only occur in the blood incidentally, hav¬ ing been taken in excess in the food, and being absorbed and carried by the blood to the various organs capable of eliminating them. This seems to be particularly true of the various compounds of soda, es¬ pecially sodium chloride, or common salt, which is found in the human system almost exclusively in the blood, merely a trace being found even in the bones, the hardest of all the tissues of the body. Functions of the Blood. — As before remarked, the blood not only supplies to the various tissues material from which they may re¬ plenish themselves, but washes them free from the poisonous products of vital activity, which are conveyed to the various organs designed to remove them. It will be interesting to, consider briefly the work performed by the two varieties of corpuscles found in the blood and already described. Function of the White Blood Corpuscles.-- The principal use of the white corpuscles probably is to ultimately become red ones, which have the most important work to perform. It is probable, also, that the white corpuscles have something to do with nutrition, since it has been noticed that they are most abundant at points where some injury has occurred or where repair is necessary for some other cause. Function of the Bed Blood Corpuscles. — The red blood cor¬ puscles are probably the most immediately necessary to life of any of the elements of the body, if we except some of the nerve centers. This is well shown by the fact that many persons when nearly dead from loss of blood have been quickly recovered by the injection into the veins of fresh blood from which the fibrine had been removed, leaving only the corpuscles and serum. When serum alone has been used, no appreciable result has been obtained, but when the corpuscles are used with the serum, even though the nutritive fibrine be removed, 220 ANATOMY , PHYSIOLOGY, AND HYGIENE. the effect is sometimes almost as marvelous as the restoration of the dead to life. Indeed, it is stated on good authority that a dog which had been bled to death, after having blood from a living dog injected into Ins veins, got upon his feet and walked a short distance. Almost equally marvelous experiments have been made with human beings, decapitated criminals being used for the purpose. The chief business of the red corpuscles is to carry oxygen from the lungs to the tissues. Oxygen is the most essential to life of all the elements received into the system. The lungs are the organs by which it is taken into the body, and the red blood corpuscles act as carriers to distribute it. Each corpuscle takes on a load of oxy¬ gen about twenty times its own size, condensing it so as to make it portable, and this it carries to the capillaries, where the load of oxy¬ gen is laid off and a smaller load of carbonic acid taken on, the latter being carried to the lungs and discharged, and a new load of oxygen taken on. Ail Interesting Sight. — One of the most interesting of all the many marvelous sights revealed by the microscope, and one of great beauty and interest, is that of the circulation of the blood. The most convenient object for a demonstration of this kind is the tail of a young tadpole. The tissues near the end of the tail are so thin as to be translucent, so that sufficient light will pass through to form an image in the microscope. Almost any thin tissue can be used in the same way, as the web of the hind foot of a frog, the mesentery of a rat, or the ear of a bat. By placing one of these objects under the microscope a most marvelous sight is beheld. One who has once seen it will never forget it. Qn Plate Y will be found an excellent representa¬ tion of what may be seen with the microscope. We have never watched this wonderful spectacle without feeling impressed anew with the power and wisdom of the Great Designer and Creator of all nature. As will be seen by reference to the engraving, the capillaries form a close network of minute canals through which the blood cor¬ puscles course in narrow lines. In the smallest capillaries they follow each other in single file ; through the larger ones they pass in twos. In some of the smallest vessels the corpuscles seem to squeeze through with difficulty, being actually larger than the vessels through which they pass, which seeming impossibility they accomplish by changing their form, becoming elliptical, and going through their long way. Close inspection will bring to notice the fact that the red corpus¬ cles in their passage through the capillaries file along in the center of THE LYMPHATICS. 221 the vessel, while the white ones seem to loiter along the walls, stopping here and there a few seconds and then lazily pulling themselves along a short distance farther. If watched closely they may be seen, now and then, to make their way out of the blood-vessels in a curious fashion, by tucking themselves through the minute openings in the capillary walls very much as a ball of putty might, by changing its form, be tucked through a finger-ring. The red corpuscles sometimes accomplish the same feat, though very seldom. The corpuscles which thus leave the blood channels do not find their way back again, but are carried to the heart by means of the lymph channels, — to be next described, — thus being saved and again used so long as they are serv¬ iceable. The capillary circulation has recently been observed in human be¬ ings by an eminent physiologist who discovered a means of making visible the capillaries and corpuscles in the lip. THE LYMPHATICS. The lymphatic system differs from the circulatory system of blood¬ vessels in that it has but one set of vessels, all of which run in the same direction, toward the center of the body. The lymphatic system also differs from the arterial and venous systems in that it has few large trunks, being almost wholly made up of minute vessel which constantly communicate with each other in all parts of the body. In certain localities there are found small gland¬ ular bodies about which the lymphatic vessels seem to col¬ lect, or from which they seem to radiate. These are known as lymphatic glands. They are chiefly found in the vicin¬ ity of the groins, the armpits, the neck, beneath the knee, in the bend of the elbow, and among the folds of the small intestine. See Figs. 105, 10G, and 107. The smallest vessels seem to originate in the connective tissue spaces, in all parts of the body. In the mucous membrane of the small intestine they originate in minute protuberances known as villi, which will be described hereafter. All the lymph vessels of the lower extrem- Figr, 105. Lymphatic Glands. 222 ANATOMY, PHYSIOLOGY , AND HYGIENE. rig. 106. The Lymphatic Vessels and Glands of Ihe head and neck. ities, the abdomen, and left half of the upper part of the body, empty their contents, directly and indirectly, into a large duct known as the thoracic duct, which passes up at the back part of the cavity of the abdomen and the thorax and empties into the left subclavian vein. Those of the right half of the upper part of the body are drained by the lymphatic vein, or duct, which empties into the right subclavian vein. The contents of the lymphatic vessels is a clear, limpid fluid, which, when examined chemically and microscopically, is found to contain a fluid substance similar to the serum of the blood, except that it con¬ tains more of the waste or excrementitious elements than the blood. It also contains large numbers of corpuscles called lymph corpuscles, FUNCTIONS OF THE LYMPHATICS. 223 which are similar to, and undoubtedly identical with, the white corpuscles of the blood. The motion of the lymph fluid is toward the center of the circulation, being only in one direction. Like the venous system, the lymph vessels have valves so arranged as to allow of a current in but \i k™\ . ° Mill one direction. These valves are much more nu- merous m the lymphatics than in veins, as will be seen by reference to Fig. 108. In some low¬ er animal forms, as in frogs, there is a distinct lymph heart which propels the lymph fluid in the vessels. There is no such force in operation in man and higher animals, however, and it is prob¬ able that the current of fluid in the lymphatics is chiefly due to the forces which aid the venous circulation; viz., the pressure of fluid from the heart, which is being constantly propelled into the tissues, the contraction of the muscles, acting in conjunction with the valves, and tbe suction force of the lungs in the act of inspiration. Functions of the Lymphat¬ ics. — As would be readily sur¬ mised from the structure of the lymphatic system, its principal function is absorption. From the skin, which is abundantly supplied with lymph vessels, water and many substances in solution may be absorbed, and thus taken into the system. A case is on record in 'which a boy in a London hospital, suffering with diabetes, absorbed nine pints of fluid through the skin in twenty-four hours. The por¬ tion of the lymphatic vessels which are most active in absorption are distributed in the mucous membrane of the intestines, where, as al¬ ready remarked, special facilities are afforded for the absorption of fluids by means of villi, projections of mucous membrane which float in the fluid to be absorbed. Through these channels — in this Fig1. 107. Shows Lym¬ phatic Vessels of the arm. Fig. 108. The Lymphatic Vessels showing Valves. 224 ANATOMY, PHYSIOLOGY, AND HYGIENE. part of the body known as lacteals — much of the food finds its way into the system. Absorption is also going on all through the body. Worn particles and waste products of all the tissues find their way to the heart through the medium of the lymph vessels. It is through these channels, also, that the white blood corpuscles, which, as we have already seen, sometimes escape through the capillary walls, find their way back to the blood-vessels. It is supposed, also, by many of the most eminent physiologists that the lymphatic glands manufacture white corpuscles. HYGIENE OF THE CIRCULATION, Although the heart and blood-vessels are the least subject to serious direct injury of any part of the body, the circulatory apparatus is of all parts of the system the most liable to derangement, from sympathy with other parts. No part of the system can become in any way im¬ paired without affecting the circulation, so universal and intimate are the sympathies established by the nervous connections of the heart and blood-vessels. Exercise Necessary for a Healthy Circulation. — An abundance of muscular exercise is essential for the health of the circulatory appa¬ ratus. As already observed, the movements of the muscles in contract¬ ing squeeze the blood out of the small veins and press it onward toward the heart. This compels the heart to beat faster in order to dispose of the increased amount of blood which is brought to it, by which means two excellent results are obtained : 1. The impure, venous blood is sent to the lungs, — which in turn act writh greater rapidity, — and is there purified and returned to the heart, so that the purity of the blood is in¬ creased by the exercise, notwithstanding some wraste products from muscular action are added to it ; 2. The heart, by beating faster, sends an increased supply of blood not only to the muscles, but to all the or¬ gans and tissues of the body ; and thus each part is enlivened and in¬ vigorated by the increased quantity of fresh, vitalized blood circulating, through it. This increased activity of the circulation is not only bene¬ ficial to the muscles, nerves, and other tissues of the body, but also to the heart and blood-vessels themselves. The heart is a muscle, and by vigorous contractions it becomes strong, as would any other muscle. The proportionate strength of the heart is well shown by a simple ex¬ periment. Let two persons, one who is not accustomed to active mus- DANGERS OF EXCESSIVE EXERCISE. 225 cular exercise, and another who uses his muscles vigorously every day, each count his pulse while standing. Now let both walk briskly or run a few rods, or up and down stairs two or three times. Upon counting the pulse a second time it will usually be found that the pulse of the sedentary person is very much more excited than that of the person ac¬ customed to exercise. This shows that his heart is weaker, and is com¬ pelled to make much more violent exertions to accomplish a little extra work than a heart accustomed to demands of that sort. It is for this reason, mainly, that persons unaccustomed to running or walking usu¬ ally get out of breath so quickly, while one trained in this kind of ex¬ ercise will endure it with apparent ease for hours. Vigorous exercise, of course avoiding excess, makes strong muscles and a vigorous heart. Dangers of Excessive Exercise. — While a proper amount of ex¬ ercise is important and essential to the health of the circulatory system, it should be borne in mind that excess is not only detrimental but danger¬ ous. Violent exertion on the part of one unaccustomed to exercise is often productive of the most serious injury ; and even those who have been trained to violent exercises often suffer great detriment. Instances have occurred in which rupture of a blood-vessel has resulted from violent straining in lifting, j umping, or trapeze performances. It is well known that the valves of the heart hi professional oarsmen are not in¬ frequently torn loose by the strain induced by rowing. Under violent muscular exertion the pressure of the blood in the arteries is very greatly increased, hence the danger. Violent exercises should always be avoided as in no way beneficial, and always detrimental and dangerous. All the advantages to be gained by exercise can be derived from such moderate exercises as have already been recommended in connection with the sub¬ ject of the “ Hygiene of the Muscles,” and will be more fully described in a chapter especially devoted to the subject. Proper Clothing Essential to Healthful Circulation. — We cannot in this connection consider more of this broad subject of clothing than has an immediate bearing upon the subject in hand, and need not, as we have elsewhere devoted a chapter to its consideration. Undoubt¬ edly the prime object in clothing is to satisfy the demands of modesty ; but besides this, the greatest want supplied by artificial covering of the body is the necessity for an equable temperature. This can only be at¬ tained by clothing all parts of the body in such a manner as to secure the natural degree of temperature for its several parts, adapting the clothing to the climate and season of the year. Failure to regard this 15 226 ANATOMY, PHYSIOLOGY, AND HYGIENE. law is probably more common than the opposite. One-half of the hu¬ man family, at least, are habitually clad in a manner which totally ig¬ nores the requirements of nature in this regard. It is an exceedingly rare occurrence to find a woman who clothes her arms and limbs as nature requires them to be clad for health, at any rate among civilized nations. The women of barbarous tribes and nations are more sensible in this regard, and imitate their husbands and brothers in clothing then- limbs as warmly as nature and the exigencies of climate demand. Civ¬ ilized women not only neglect themselves — we should properly say abuse themselves — in this regard, but their children are allowed to suffer from the same cause. Thousands of these little innocents have been sacrificed to the insatiable Moloch of Fashion The extremities, being farthest from the great centers of heat and life, evidently need more clothing than other parts more favorably lo¬ cated ; but they commonly receive less. This is an evil, the magnitude of which can scarcely be overestimated. We have no hesitation in ven¬ turing the assertion that thin shoes and stockings, and bare arms and legs, kill more children every year than the infamous Herod murdered in Bethlehem. Every philanthropist ought to join earnestly in the work of effecting a reform in this direction. Little reward can be ex¬ pected, however, for this kind of work in the present generation. The results would be best seen in the next, in the effective labors of thou¬ sands whose lives are now made useless by disease, the foundation of which was laid in early childhood by the evil practice in question, and of thousands of others who to-day are filling tiny graves which ought to have remained vacant for at least threescore years. Every mother who becomes enlightened on this subject ought to communicate the knowledge she has gained to the mothers in the circle of her acquaint¬ ance. By this means, together with the influence of example, we might hope for good results. There has been recently organized in New York City a society, the stated object of which is the prevention of cruelty to children. We would most earnestly commend to their attention this question of proper clothing, and we doubt not that the amount of good they might do by propagating correct principles on this subject would far exceed the good results in all other departments of their work. Evil Effects of Constriction. — Constriction of any part of the body is certain to be followed by evil consequences. Suppose, for ex¬ ample, a string be tied tightly around the finger. Every one is fa¬ miliar with the fact that the finger thus ligated will speedily lose its EFFECTS OF FOOD ON THE CIRCULATION. 227 natural color, become dark and as quickly lose its natural warmth, becoming cold, and that notwithstanding its swollen condition due to the superabundance of blood. An elastic around a limb will have precisely the same effect upon the foot, though in less degree. The circulation being obstructed, less blood than is necessary to health flows through the foot, and it is habitually cold ; and from the con¬ stant interference with its nutrition, it becomes shrunken and weak. The use of elastics is well known to be a cause of thin calves. A constriction about the waist, from compressing the stomach, liver, and other internal organs, must do an immense amount of harm to the body by interfering with the functions of these important organs. It makes no difference whether the constriction is due to a tightly drawn corset or to the bands of skirts hung upon the hips, or to a belt tightly clasped ; the effect is the same. An English medical journal is authority for the statement that in that country quite a large proportion of women upon whom post-mortem examinations are held are found to have their livers malformed from compression due to this very cause. We have seen cases in which the liver was cut nearly in two, and cases are reported in which the liver had actually been divided by this cruel process. By the interference with the cir¬ culation in abdominal organs, piles or hemorrhoids is induced, with painful local disorders peculiar to females. Constriction of the throat is an evil not now so common as in former days when the old-fashioned cravat was worn ; but occasion¬ ally care is not taken to secure the degree of freedom about the neck which is essential to health. It requires but a very slight constric¬ tion of the neck to interfere with the circulation of the head suffi¬ ciently to occasion very unpleasant and even serious symptoms, such as headache, dullness, and vertigo; even apoplexy may be induced in this way. Effects of Food oil the Circulation. — As the blood is made of what we eat, it is evidently of the greatest consequence that what is taken into the stomach for the purpose of making blood should be of the very best material. Poor food will make poor blood, which will, in turn, make all the tissues of poor quality. Certain kinds of food, as what is termed rich food, or that which contains too much of sugar, fats of various sorts, and condiments, deteriorate the blood, both directly and indirectly. Directly, by filling it with useless or super¬ abundant material; indirectly, by rendering the liver sluggish and in- 228 ANATOMY, PHYSIOLOGY, AND HYGIENE. efficient, thus occasioning an increase in the elements which ought to be removed as bile. Other foods damage the blood by filling it with material which is not only directly injurious to the blood itself, but to all the tissues with which it comes in contact, whether in finding their way into the blood through the stomach or out of it through the liver, kidneys, skin, bowels, and other eliminating organs. Of this character are most condiments, as will be shown in treating of the subject of “Food and Diet,” as well as in connection with “The Hygiene of Digestion,” to which we would invite the further attention of the reader. Narcotics and stimulants must not be overlooked in this connec¬ tion, for their influence for evil upon the heart and the circulation is too great and too well determined to allow of the possibility of doubt, or the need of waiting for further evidence. Alcohol, tobacco, hashish, opium, absinthe, even tea and coffee, must be included in the category of harmful agents of this class. The manner in which each of these agents operates in effecting its evil work must be left for special con¬ sideration in a chapter devoted to the subject. Injurious Effects of Cold . — Cold paralyzes the heart, and to its depressing influence is due the fact that so large a propor¬ tion of aged persons die in the cold season of the year. Having lost ~ in some degree their power to produce animal heat, they quickly succumb to the exposures incident to the inclement season of the year. Hence it is important that the old, of all others, should be warmly clad in winter. There are current many incorrect notions respecting the means of protection from the injurious in¬ fluence of cold. The idea that stimulants will enable a person to withstand cold has been long exploded. The uniform testimony of physiologists and Arctic explorers is to the very reverse. Physi¬ ologists find by actual experiment, testing the temperature of a person both before and after the imbibition of spirits, that the tem¬ perature is uniformly lowered by alcohol in all forms. Arctic navi¬ gators say that for a man to take alcohol when traveling amid the snow and ice of the frozen regions of the North, where the tempera¬ ture is often 70° F below zero, is almost certain death. Alcohol makes a man feel warmer, but really abstracts heat from him. So with to¬ bacco, which many persons habitually smoke, in the winter to make them warm and in the summer to keep them cool. It depresses the action of the heart, and consequently diminishes the amount of heat EVIL EFFECTS OF HEAT. 229 produced. The best means of protection are those which will raise the vital tone, strengthen the force of the circulation, and thus increase the manufacture of heat, while proper means are taken to preserve and economize that which is produced. Cool bathing for the robust is a splendid method of augmenting animal heat. . The use of the oil-bath is an excellent means of protection from cold. A gentleman who was able to speak from experience said very truthfully that an inunction was as good as an extra overcoat. Many persons make the great mistake at the beginning of cold weather of shutting themselves up indoors with hot stoves or furnaces, confining themselves to avoid taking cold. This is the most certain way to prepare one’s self to acquire a cold upon the slightest provocation. A person may become so tender and susceptible by following such a plan that simply opening the window for a breath of fresh air, stepping to the door to admit a friend, or the most trivial degree of exposure will be sufficient to bring upon him the most severe effects of “ taking cold.” All persons, particularly those who are specially sensitive to cold, even in¬ valids, should, at the beginning of winter, begin to accustom them¬ selves to cold. Thus by degrees their susceptibility may be overcome in a very large measure, if not wholly. Daily exercise in the open air, and a daily bath with friction of the skin and inunctions, with plenty of good food and abundance of sleep are also important means of fortify¬ ing the system against the ravages of cold. Evil Effects of Heat. — Excessive heat has a still more disastrous effect upon the circulation than cold, as is evidenced by the large number of cases of sudden death which annually occur from “sun¬ stroke ” and “ heat-stroke.” That this malady is really due to heat and not to the influence of the sun, as many suppose, is evidenced by the fact that many cases occur among factory operatives, furnace men, stokers in ships, and other persons whose occupation is wholly indoors. The remedies for this affection are given in the proper place. As it is often fatal, its prevention is of equal importance with its cure. Those who have had the most extensive experience with this disease assert that those who suffer from it are, as a general thing, persons who are in a debilitated condition from overwork, loss of sleep, dissipation, the use of alcohol, or poor and insufficient food. Stimulants are especially condu¬ cive to the disease. All these predisposing causes should, of course, be avoided, as well as the exciting cause already indicated. Persons who are exposed to excessive heat in the summer season should take care to 230 ANATOMY, PHYSIOLOGY, AND HYGIENE. keep the head cool, which may be accomplished by means of a cloth wet in water and worn inside the hat, by very frequent wetting of the head, by the use of umbrellas in the sun, and by other means which special circumstances may require or suggest. Fig. 109 illustrates a mode of keeping the back part of the head cool in hot weather which may be adopted with advantage by those whose occupation obliges them to be much exposed to the sun. The habit of frequently applying ice or ice-cold water to the head in hot weather is likely to be productive of injury. The head is cooled for the moment, but a reaction soon takes place, and then there Is a greater determination of blood to the head than ever. It is best to employ for bathing the head, water which Is only moderately cool, and then depend on the evaporation to produce the necessary cooling effect. Ice and iced-water should be used only in cases requiring sudden and ex¬ treme cooling of the head, and then should be con¬ tinuously applied until the desired effect is obtained. The natives of Africa protect themselves from the intense heat of the tropical sun to which they are exposed by smearing their bodies with ghee> It is difficult to see what benefit can be derived from such a proceeding, but it is possible that the smooth, oiled surface of the skin may reflect the solar rays of heat and thus protect the body from their influence, at least to some extent. Fig-. 109. A means of protecting the back of the head and neck from exposure to the sun. a kind of ointment. THE RESPIRATORY APPARATUS. 231 THE RESPIRATORY APPARATUS. Fig. 1 10. The Pharynx, shown by slittingthe cheeks at the corners of the mouth ; 6. Mouth of ductfrom the pa¬ rotid gland; 7. Eoof of mouth; 8. Posterior nares; 9. Fau¬ ces; Uvula; 11. Tonsils; 13. Tongue. The respiratory apparatus consists of the air-passages, the lungs, and the thorax, each of which will be briefly described. The Air-Passages. — These consist first of the mouth, the nose, the 'phar¬ ynx, or back part of the mouth, the trachea, or wind¬ pipe, the upper part of which is also called the larynx, and the bronchial tubes. The mouth needs no precise de¬ scription. The nose or na¬ sal cavity consists of a hollow left between the bones of the face and those of the skull, which is divided into two parts by a bony and cartilaginous septum, each compartment communicating separately ex¬ ternally through the anterior nares, or nostrils, and with the back part of the mouth through the posterior nares. The trachea, or windpipe, is a flexible open tube situated just in front of the meat pipe, or gullet, and is composed chiefly of rings of cartilage connected together by membrane. These rings are not quite complete at the back side, the space being filled by muscular tissue. The larynx is the upper part of the trachea, and consists of a cai'tilaginous box across which are stretched four deli¬ cate ligaments, the vocal cords, the up¬ per two being the false, and the lower the true vocal cords, which are con¬ cerned in the production of the voice. Fig. 111. Tbe Larynx. 6. Thy¬ roid Gland. 232 ANATOMY, PHYSIOLOGY, AND HYGIENE. The top of the larnyx is guarded by a cartilage, the epiglottis, which is shaped somewhat like a leaf, and has a hinge-like attachment to the upper end of the windpipe, so that when the tongue is drawn back, as in swallowing, it will fit down upon the larynx like a cover, and completely close it. By this wonderful provision of nature, both solids and liquids are prevented from en¬ tering the trachea while eating or drinking. A patient in Bellevue Hospi¬ tal, New York, whose epiglottis had been destroyed by disease, had great difficulty in swallowing on ac- count of the frequent entrance of particles of food into the tra¬ chea, causing violent coughing. The car¬ tilages of the larynx form the prominence in the throat just below the chin, which moves up and down in swallowing, and is popularly known as Adam’s apple. The bronchial tubes are simply continuations of the trachea, which divides into two branches in the chest, one of which enters each lung and there subdivides until the tubes become not more than jhg- of an inch in diameter, when they terminate in the air-cells. After the bronchial tubes become so small as fa of an inch, the carti¬ lage disappears from their walls, so that the small bronchial tubes, or bronchioles, have membranous and muscular walls. The air-passages are lined throughout with mucous membrane. The epithelium of the windpipe and bronchial tubes is very peculiar, consisting of cone-shaped cells, the large ends of which are covered with delicate hairs. These are kept in constant motion, always wav¬ ing in the same direction, by which means there is maintained a con- Fig;. 112. The Air-Passages. THE LUNGS. 233 stant current of mucus in the direction of the mouth. The evident purpose of this arrangement is the protection of the lungs from dust, which will he caught in the stream of mucus and carried to the mouth for expulsion. The relative position of the several portions of the air-passages is well shown in Fig. 112. o The Lungs. — The real structure of the lungs is seen only by ex¬ amination with a powerful microscope, which shows the pulmonary tissue to be made up almost wholly of small cells and minute capillary blood-vessels, together with the small bronchial tubes. These several elements are somewhat loosely held together by bands of yellow elastic tissue, of which a great share of the lung substance is com¬ posed. The cells are arranged in groups of fifteen or twenty, which are called lobules. Each lobule is attached to the end of a bronchiole with which it communicates. Fig. Fig1. 1 13. Lobules of Lung, showing at a end „ . . ... ...of bronchial tubes, and at c e air cells. 113 shows two or the lobules with the end of the small bronchial tube with which they are connected. The number of cells in the lungs has been calculated to be not less than seventeen hundred million (1,700,000,000). The lung cells as well as the air-passages are lined with a mem¬ brane which is so very thin that twenty -five hundred layers would be required to make an inch in thickness. The extent of this mem¬ brane is very great, owing to the great number of the cells. It has been estimated that if spread out its area would be not less than two thousand square feet. Underneath this thin membrane is spread out, in the walls of the cells, the closest network of capillaries in the body. So small are they that only a single blood corpuscle can pass through at once, and so near are they placed together that they occupy fully three-fourths of the entire surface, great as it is. Through these minute channels pass over fifteen barrels of blood every twenty-four hours. The lungs occupy the two sides of the chest, the cavity of which they nearly fill. The right lung is divided by two deep fissures into three portions, called lobes. The left lung consists of two lobes. Both lungs are covered over with a delicate serous membrane, the O pleura, which also lines the chest walls. 234 AX ATOMY, Pll YSIOLOGY, AND HYGIENE. The thorax is the upper of the two cavities into which the trunk of the body is divided, being separated from the abdomen by the dia¬ phragm, a muscular organ which has been already described. It is made up of its bony framework — the ribs, vertebrae, and sternum — and the muscles which lie between the ribs and about the upper part of the chest. It is lined by the same membrane which cov¬ ers the lungs, the pleura. The lungs lie in immediate contact with its inner walls, but are perfectly free from attachment to it. The thorax contains, in addition to the lungs, the heart and the great blood-ves¬ sels, together with im¬ portant nerves. Con¬ nected with the tho¬ rax and accessory or- Figr. 114. Cut showing the relation of the Lungs and Heart. gang q£ respiration are several sets of muscles which aid in expanding and contracting the cavity of the thorax. PHYSIOLOGY OF RESPIRATION. The lungs are the means by which the system receives gaseous food. It is received all ready for use by the system, no elaborate prep¬ aration being required as in the case of solid food taken by means of the stomach. Of the three kinds of food received by the body, solid, liquid, and gaseous, air is by far the most immediately essential to life. A person may live many days without solid food, and several days with neither solid nor liquid aliment ; but death occurs in a few minutes when the supply of air is cut off, as in suffocation or drown¬ ing, a fact which indicates with sufficient clearness the importance of the subject. MOVEMENTS OF RESPIRATION. 235 Fig-. 115. Cut showing how the ca¬ pacity of the chest is enlarged by ex¬ pansion of its walls and depression of the diaphragm. Movements of Respiration.— The acts of respiration are two, — inspira¬ tion and expiration. These two acts are performed by changes in the size of the thorax. In producing inspiration, the thorax is made larger, by depres¬ sion of the diaphragm — which elongates the chest cavity — and elevation of the ribs, which enlarges the chest laterally. In consequence of the increased space in the thorax, the air simply rashes in to occupy the room made for it. It should be noticed in this connection that the air does not force its way in, but simply enters when invited by room being made for it. In expiration, the opposite takes place. The ribs are low¬ ered, and the diaphragm, being relaxed, is pressed upward into the chest by the contraction of the abdominal mus¬ cles. The natural elasticity of the lungs also aids in expiration, as they are for¬ cibly distended during inspiration, and naturally tend to return to their normal state, which is undistended, as at birth. There are said to be three kinds of res¬ piration, according to the portion of the luims which is most active. When O the breathing is performed mostly by the diaphragm, it is termed abdominal respiration ; when the lower portion of the ribs is used, inferior costal; and when the upper part of the chest is em¬ ployed, superior costal. The last-named is the most common respiration in women, which is said to be natural for them, but which, in our opinion, is due to the fact that by their mode of dress the lungs are usually confined so that only the diaphragm and upper ribs can operate freely, the Fig. 116. A lateral view illustrating the same as Fig. 1.5. 236 ANATOMY, PHYSIOLOGY, AND HYGIENE. chest being effectually hindered from lateral expansion by the em¬ ployment of tight-lacing with or without the use of corsets. For change in size and appearance of chest during respiration, see Figs. 115, 116, 117, 118. Frequency of Respiration.— The general law of respiration re¬ quires one respiratory act for every four heart-beats. As the pulse is seventy-two to eighty per minute in the adult, respiration is from eighteen to twenty during the same time. The frequency of respira¬ tion is increased and diminished by the same causes which affect the pulse rate. It is notably increased by exercise, heat, and stimulants, and diminished by sleep and by cold. During the hibernation of an¬ imals respiration is so slight and infrequent as to be almost impercep¬ tible, the pulse being diminished proportionately. Coughing, Sneezing, Laughing, and Other Modifications of Respiration. — Most of these modifications of the respiratory act are more or less involuntary, though to some degree controllable by the will. Coughing and sneezing consist of a prolonged inspiration fol¬ lowed by a forcible exhalation, produced by a convulsive expiratory effort, the air, in coughing, being expelled wholly through the mouth, in sneezing by both mouth and nose, though chiefly by the mouth, contrary to the usual opinion. Sighing is a deep and prolonged in¬ spiration, followed by a rapid and audible expiration. A slight sigh naturally occurs every seventh or eighth respiration, by which a more complete change of air in the lungs is effected than in ordinary breathing. Yawning is similar to sighing, except that the mouth is widely opened during inspiration and that it is involuntary. It is a curious fact that yawning is contagious in a remarkable degree. A person who is able to imitate yawning well may by adroit manage¬ ment set a whole company of people yawning. Laughing and sobbing differ more in the character of the emotions which they accompany than in the mode of production. Both acts result from short and convulsive movements of the diaphragm, accompanied by contraction of the muscles of expression. Hiccough is a modification of inspira- - tion, being due to sudden contraction of the diaphragm. It is usually indicative of derangement of digestion, being often caused by rapid eating and by the use of effervescing drinks. Capacity of the Lungs. — The cubic contents of a pair of well developed lungs is about three hundred and twenty cubic inches. Of VITAL CAPACITY. 237 this quantity but a small part is used in ordinary respiration, not more than twenty cubic inches. It is possible, however, after making an ordinary expiration of twenty cubic inches, by a strong effort to force out one hundred cubic inches more. It is also possible after an ordinary inspiration to inhale, by a strong effort, one hundred cubic inches extra. Thus after a forcible inhalation a person may expel from the 1 liners two hundred O and twenty cubic inches of air ; but there always remains one hundred cubic inches of air in the lungs which cannot be expelled. The object of this great surplus of breathing capacity is to provide for contingencies of various sorts which are continually arising, and which make demands for an increased quan¬ tity of air. It is to this that is due the fact that persons may even live for years after one lung has become entirely useless, examples of which we have several times met in our own practice. The comparative capacity of the lungs after inspiration and after expiration is well shown in Figs. 117 and 118. Fig:. 117. Fig-. 118. Fig. 117. Relative capacity of the Chest and position of the Diaphragm after a complete Expiration. Fig. 118. Relative capacity of the Chest and position of the Diaphragm after a full Inspiration. Vital Capacity. — The amount of air that can be changed at one respiration is called the vital capacity of an individual. Dr. Hutchin¬ son has shown that vital capacity depends much upon the height, and increases regularly at the rate of eight cubic inches for every inch of increase in height between five and six feet, being about one hundred and seventy-five cubic inches for a person five feet in height, and about two hundred and fifty-five cubic inches in persons six feet in height. The vital capacity can be greatly increased by proper train¬ ing, as we have often demonstrated in the treatment of consumptive patients. 238 ANATOMY , PHYSIOLOGY, AND HYGIENE. Composition of the Air.— The air we breathe is a simple mixt¬ ure of numerous gases, the chief of which are oxygen and nitrogen, the former constituting about one-fifth, and the latter four-fifths of the whole, the other gases being so minute in quantity that they need not be taken into account, with the exception of carbonic acid, or more properly carbon di-oxide, and watery vapor. Of the former the air contains about four parts in ten thousand ; and of the latter a va¬ riable quantity. That is, in one hundred cubic inches of air there are about twenty cubic inches of oxygen (20.89), and about eighty cubic inches of nitrogen (79.11); and in ten thousand cubic inches of air there are four of carbon di-oxide. Besides these the air contains slight quantities of the various gases given off in animal and vegetable decomposition, and arising from the numerous chemical and physical changes going n upon the surface of the earth, together with dust and various other foreign matters, all of which may be considered im¬ purities, the nature and dangers of which will be elsewhere explained. For animals, and, in fact, according to recent discoveries, for all living forms, vegetable as well as animal, the oxygen of the air is the essential element. Life is dependent upon its regular and ade¬ quate supply more than upon any other element. The nitrogen of the air is only useful to dilute the oxygen, as in an atmosphere of pure oxygen we should live so fast as to be very short-lived. Experiments with animals show that prolonged inhala¬ tion of air in which the proportion of oxygen is much different from that in which it naturally occurs in the atmosphere produces great disturbance of the system and finally death, from which it appears that the mixture which we call air is not an accidental compound, but one admirably adapted to the wants of human beings as well as lower animals and even plants. The carbonic acid in the air is the result of animal and vegetable decomposition, combustion, and the respiration of plants and animals. It is not necessary to human life, but is essential to the life of plants, of which it constitutes one of the principal forms of food, another ad¬ mirable adaptation of nature by which what is poisonous to one part of the animate creation is essential to the existence of the other. Plants require carbonic acid, or carbon di-oxide, as food, yet they re¬ spire oxygen, as do animals. This fact has not been known until re¬ cently. The watery vapor of the air is necessary to enable the lungs to CHANGES IN THE BLOOD IN RESPIRATION. 230 utilize the oxygen readily, it being found by experiments that dry oxygen is absorbed much less rapidly than that which contains a due proportion of moisture. Changes in the Air During Respiration. — Upon examining the air which is exhaled from the lungs it is found that while passing through these organs it undergoes certain changes, both losing and gaining certain elements. The air taken into the lungs in an ordinary respiration — Loses about one cubic inch of Oxygen. Gains about one cubic inch of Carbonic Acid Gets. Gains about one cubic. inch of Watery Vapor. Gains about one cubic inch of Organic Matter. During forced respiration, when a larger quantity of air is inhaled, the quantity of oxygen lost in the lungs and the amount of carbonic acid gained are of course greater, which is also true of the other changes mentioned. It should be remarked that the amount of car¬ bonic acid gained is a little less than that of the oxygen lost. Changes in the Blood in Respiration. — The changes which occur in the blood while passing through the capillaries of the lungs are equally marked. When the blood enters the lungs from the pul¬ monary artery, which brings it from the right heart, it is of a dark pur¬ ple color, its color being due to the impurities which it contains, the chief of which is carbonic acid. When the blood leaves the lungs, it is of a bright red color, having exchanged its carbonic acid for oxy¬ gen, which is absorbed by the red corpuscles to be conveyed to every part of the system, being assimilated in the capillaries of the tissues and changed to carbonic acid, which is brought back to the lungs in the venous blood. Other impurities are also given out in the lungs, constituting the organic matter of the expired air. The blood also loses a little of its water in passing through the lungs, and is slightly cooled. The last-mentioned fact completely refutes the old theory of an eminent chemist, which is still believed by some, that the lungs are a sort of furnace in which the carbon of the blood is consumed as coal or wood is consumed in a stove, since if the theory in question were true, the blood would gain heat in the lungs instead of losing. The blood and air are brought into such close contact in the lungs, being only separated by the delicate membrane already described, which is not more than an inch in thickness, that the change 240 AX ATOMY, PHYSIOLOGY , ^BVD HYGIENE. of gases takes place with the greatest facility. Indeed, it is believed that the membrane lining the air-cells facilitates, rather than hinders, the escape of the carbonic acid in the lungs and the absorption of oxy¬ gen. When it is considered that nearly five hundred gallons of blood are thus purified every day (the same blood being purified over many times), for which more than eighty barrels of air are required, it is readily seen that there is abundant necessity for the two thousand square feet of membrane devoted to this purpose in the lungs. By this process of indirect combustion, in many respects analogous to the burning of coal on a grate or of wood in a stove, or the burning of a candle or a gas jet, more than half a pound of solid carbon is daily consumed in the body. In persons whose occupation is very laborious, more than three-quarters of a pound is thus daily consumed. The amount of carbonic acid exhaled is modified by several other influences besides exercise, as age, sex, diet, etc. The largest amount is exhaled during the prime of life, gradually increasing from infancy to that period, and declining during advancing age. Females exhale much less than males. Much more is produced during digestion than at other times, the amount being particularly increased by certain articles of food, as sugar and animal food, and especially by stimulants, wine, rum, beer, ale, cider, and even tea and coffee, a fact which com¬ pletely refutes the argument made in favor of the last-named articles, that they diminish the waste of tissue, since it is evident that they in¬ crease it. These facts were chiefly established by the experiments of the late Dr. Edward Smith, of England. During sleep the amount of carbonic acid exhaled is greatly diminished. In the winter sleep of some hibernating animals it is reduced to less than ^ of the ordinary amount. Violent exercise may increase the quantity of carbonic acid exhaled to six times the ordinary amount. In a dry atmosphere the mucous membrane of the lungs becomes dry, and thus loses in a con¬ siderable degree its power to transmit gases, so that the amount of carbonic acid is greatly diminished while breathing it. Respiration of the Skill.— The lungs are not the only respira¬ tory organs. The skin also participates in the process, though it does but a small amount compared with the lungs, the proportion being not more than one to forty. In some lower animals, as in the frog, a much larger amount of respiratory work is done by the skin. LUNG EXERCISE. 241 HYGIENE OF RESPIRATION. Under this head we shall dwell specially on such portions of the subject as pertain particularly to the lungs, leaving the hygiene of the air and the subject of ventilation for more complete and explicit con¬ sideration in a separate chapter. Lung Exercise. — No part of the body is susceptible to greater improvement from systematic exercise, or suffers greater detriment from neglect of exercise. When the lungs are not well expanded habitually, they gradually lose, to some degree, their elasticity, so that the power to expand them is lost. In the physical examination of hundreds of chests we have had occasion to notice, in scores of in¬ stances, the almost total loss of pow¬ er to expand the chest. If asked to do so, the patient would shrug his shoulders, perhaps elevate them as high as possible, and make a despe¬ rate attempt to get a little more air than usual into his lungs, accom¬ plishing but very little in that di¬ rection, however, as the tape-line placed about the chest showed no appreciable increase in size. We have often found persons in this condition, whose chests ought to have measured two to four inches more when filled than after inspiration. The Spirometer. — The use of the spirometer is an excellent means of noting the change which can be made in the vital capacity ©f the lungs by systematic exercise persevered in daily for months. This instrument is shown in Fig. 119. As it is very simple, it can be made by any tinsmith at an expense of a few shillings. The instru¬ ment consists of two tin vessels, one inverted inside the other. The larger one should be nearly filled with water, and should have a small tube passing up through the center nearly to the top. This should communicate with a flexible tube outside, to the end of which is at- 16 Fig. 119. Spirometer, a. Inner vessel, with which the inhaling tube communicates ; 6. Outer vessel containing water ; c. Scale in¬ dicating the number of cubic inches inhaled. 242 ANATOMY, PHYSIOLOGY, AND HYGIENE. tached a mouth-piece which may consist of a short glass tube with a good-sized bore. By blowing into the tube the inner vessel will be made to rise, and the amount of air expelled will be indicated by a scale accurately determined by previous calculation or experiment, and marked on the outside. If the inner vessel is eight inches in di¬ ameter, a scale may be made with lines one-tentli of an inch apart, each of which will represent five cubic inches of air. A person five feet high ought to be able to raise the scale three inches and a half after taking a full inspiration. A person six feet high should be able to raise it five inches. By the daily practice of lung gymnastics as described in the chap¬ ter on exercises, a person may increase his vital capacity from a few inches to many times as much. When a person is weary, and feels exhausted from sedentary em¬ ployment, the practice of deep and prolonged respiration with the chest well expanded, the shoulders back, and the spine erect, will be exceedingly refreshing. The great advantage of abundance of lung exercise is well seen in the fact that professional singers suffer less from pulmonary difficul¬ ties than others. A medical professor of St. Petersburg recently ex¬ amined the chests of more than two hundred professional singers in that city, and found their chests better developed than those of the majority of persons, and an almost entire absence of lung diseases. Corset Choking. — Choking is keeping air out of the lungs; at least, that is a practical definition of the word. It makes no difference to the lungs and no difference to the blood, whether the life-giving oxygen is kept out by confining the respiratory apparatus at its lower or its upper part. The result is precisely the same in either case. A man who ties a rope around his neck and kills himself by choking is called a suicide. A young lady who does essentially the same thing by lacing her waist, only taking a little longer time for it, is considered extremely fashion¬ able. Pure air is the first and the last desideratum of human life. In¬ dependent life begins with the first breath, and ends with the last act of respiration. A human being lives in proportion as he breathes. Frogs and lizards are sluggish because they breathe little. Birds are more vig¬ orous in their movements because of the wondrous capacity and activity of their lungs. So with human beings. Need we suggest that those feeble-minded creatures who emulate each other in compression of the waist — thus curtailing the breathing power — are like frogs and lizards POISONOUS CHARACTER OF EXHALED AIR. 243 in their capacity for appreciating the “joy of living”? or that their organs of cerebration may be as diminutive as their waists ? The evils of corset-wearing have already been dwelt upon quite fully, and we will not recapitulate here ; but we wish to call special attention to three ways in which the use of corsets, whether worn extremely tight or not, acts injuriously upon the lungs and respiration. 1. By compression, the muscles of respiration lose their power to act, and waste away, so that strong, deep respirations become impos¬ sible. This is the reason why ladies feel, when deprived of their cor¬ sets, as though they would “ fall all in pieces.” 2. By confinement in a stiff, unyielding case, the elastic cartilages which unite the ends of the ribs to the breast-bone so as to give free¬ dom of action become rigid, and thus prevent full expansion of the chest and filling of the lungs. 3. By compression of the lower part of the lung the upper part is crowded up against the inner border of the first rib, against which it is continually pressed, so that the constant motion and friction finally excite irritation which undoubtedly becomes the starting-point of many cases of consumption. Poisonous Character of Air Which Has Been Breathed. — As already shown, air which has been breathed contains a large proportion of carbonic acid, and besides this a poison much more deadly in its char¬ acter, organic matter, the exact nature of which chemists have never yet been able to determine. The carbonic acid is not itself greatly inju¬ rious in the quantities in which it is produced by breathing, but as it is always in about the same proportion to the organic matter, it is a relia¬ ble index to the amount of the latter poison, and so to the character of the air. It is the organic matter referred to which gives to close rooms the peculiar fusty odor with which every one is familiar. Persons who are confined in-doors most of the time become so accustomed to this warning of danger that they do not appreciate it, and hence do not heed it; but when a person who has been some time in the open air comes into a poorly ventilated room occupied by several persons, the odor is very perceptible, and the first impulse is to open the doors and windows and let the foul air out and pure air in, though the persons in the room may be wholly unconscious of the condition of things. This foul and pernicious poison is closely associated with the watery vapor of the expired air. In cold weather this vapor condenses upon the window- panes, and may be collected. The fluid thus collected forms a most fetid 244- ANATOMY, PHYSIOLOGY, AND HYGIENE. and disgusting mass after standing in an uncorked bottle for a few days. The experiments and researches of eminent scientists on the nature and effects of this poison as it exists in respired air seem to show quite conclusively that it is the principal cause of the numerous evil effects of breathing air which has been previously respired. Rapidity with which the Air is Contaminated by Breathing. — Experiments have shown that air which has been breathed over a few times contains ten per cent of carbonic acid, and of course a correspond¬ ingly large proportion of the organic poison, which is an increase from four parts in ten thousand of air, to one thousand parts in the same amount of air. According to the results which have been obtained by Parkes, Cameron, and numerous other investigators in this line of sani¬ tary science, a single breath, containing a cubic inch of carbon di-oxide renders unfit for respiration three cubic feet of air. It may be easily cal¬ culated from this, with the fact that we usually respire twenty times a minute, how long the air in a seven-by-nine bedroom may be made to last. Supposing such a room to be eight feet high and tightly closed, with one occupant in it, the air would remain fit to breathe less than ten minutes ! If bedrooms were air-tight, thousands more would have died from neglect or ignorance of this fact than have already filled premature graves in consequence. Fortunately for the human race, at least for the civilized part of it, our houses are seldom air-tight. A little air will find its way in, even through brick walls. Nature has provided us with an ample abundance of the greatest necessary of life, making it free to all, — for no despot ever put a tax upon the air his subjects breathed, — and even urging us to accept whether we desire it or not. The Effects of Breathing Impure Air. — Without going into de¬ tails these may be briefly summed up to be headache, dullness, nervousness, debility, consumption, and an aggravation of all other maladies. The headache of which school-children suffer so much is chiefly due to foul ah'. Consumption is well known to be most frequent in those whose habits or vocations are chiefly sedentary, or which keep them in a foul atmosphere. Experience in the late war showed that impure air was an important cause of rendering diseases fatal which otherwise would have been far less serious. At the first Sanitary Convention in this country, held at Detroit, Jan. 7 and 8, 1880, under the auspices of the State Board of Health of Michigan, in the discussion of a paper on ventilation, an old army sur¬ geon who had charge of large hospitals during the war, related a very EFFECTS OF BREATHING IMPURE AIR 245 interesting experience illustrating the importance of securing to the sick, and especially to persons suffering with fever, an abundance of pure air. He stated that during the war he had charge of a large hospital in which at one time in the winter season he had under treatment three hundred and twenty cases of measles. Just at this time the hospital took fire and burned to the ground. The patients were placed in tents, and all but one or two recovered. He had no doubt that the number of deaths would have been thirty or forty, at least, had the patients remained in the hospital. He afterward sent one hundred men who were only slightly ill to the general hospital at Nashville, and seventy -five of them died. Upon visiting the hospital, he found it so poorly ventilated that the air was exceedingly foul, producing a sickening sensation when he had only been in it for a few minutes. The Doctor concluded by remarking that he regarded pure air and water as most important agents, and believed them to be capable of controlling the ravages of raging disease. The best methods of receiving an abundance of pure air by ventilation, the amount necessary for each individual, and other questions of impor¬ tance pertaining to this subject are considered in another chapter. 246 ANATOMY, PHYSIOLOGY, AND HYGIENE. THE DIGESTIVE APPARATUS. Fig-. 120. The Alimentary Canal, a. (Esopha¬ gus; b. Stomach; c. Cardiac Orifice; d. Pylorus; e. Small Intestine; /. Bile Duct; g. Pancreatic Duct; h. Ascending Colon; i. Transverse Colon; j. De¬ scending Colon ; k. Itectum. The Alimentary Canal. — Fig. 120. The digestive appa¬ ratus consists of a long, tort¬ uous tube, the digestive or ali¬ mentary canal, to which are appended various accessory or¬ gans. The alimentary canal is about thirty feet in length, and is lined throughout with mucous mem- brane, which is variously modi¬ fied, according to its location. Each end of the canal is guard¬ ed by a circular muscle, the up¬ per opening, the mouth, being by this means opened or closed at pleasure, while the lower is in¬ voluntary in its action, only opening when overcome by force applied from above, a wise pro¬ vision of nature to antagonize the influence of gravitation upon the contents of the bowels, and to retain the same during sleep or other periods of unconscious¬ ness. This canal, which at an early period of development in human beings — as permanently in some simple animal forms — is merely a straight tube, in the fully developed individual be¬ comes so modified as to present at least five distinct portions, each of which possesses peculiar and important functions, and THE MOUTH— THE TEETH. 247 hence requires separate description, together with the several accessory organs which are connected with them. Although a more detailed clas¬ sification is possible, for our purpose it will be sufficient to consider the alimentary tube as divided into the 'mouth, oesophagus, stomach, small intestine, and large intestine, or colon. The Mouth. — The mouth, the upper portion of the canal, guarded by the circular muscle of the lips, contains the teeth and tongue, and presents in its mucous membrane the ori¬ fices of the ducts of three pairs of secreting organs, known as the salivary glands. The back part of the mouth, usually known as the 'pharynx, communi- nr t , * J * Fig*. 121. The Mouth. 6. Mouth of duct from the cates through the posterior Parotid Gland; r. Roof of mouth; 8. Posterior Nares; 9. . .. .. , Fauces; 10. Uvula; 11. Tonsils; 13. Tongue. nares with the nasal cav¬ ity; through the Eustachian canals, with the ears; through the upper end of the larynx, with the lungs: and through another open¬ ing at its extreme back part, with the stomach, by means of a canal known as the oesophagus. See Fig. 121. The Teeth. — Each tooth has three parts, a crown, a root, or fang, and a neck. The crown is the part which appears above the gum. It is covered with a hard, dense substance, the hardest in the body, the enamel, which is in turn protected by a very thin covering not more than -a 0 ^ o~ir of an inch in thickness, the object of which is to protect the enamel from the action of acids. The enamel prevents wear of the teeth in chewing hard substances. Its density varies much in dif¬ ferent persons, often becoming soft in consequence of disease. The interior of the tooth presents a cavity which is filled by what is termed the pulp, which is made up of delicate blood-vessels and nerves enter¬ ing the tooth through an opening for the purpose in one or more of the roots. The hard part of the tooth is chiefly made up of a bony substance called dentine, which is identical with ivory. The smaller teeth have but one fang, the larger two, or even three. The neck is simply the slight constriction between the crown and root. 248 ANATOMY, PHYSIOLOGY, AND HYGIENE. The Milk Teeth. — Two sets of teeth are furnished most persons, some being so fortunate as to acquire a third in advanced age. The first set, called temporary or milk teeth, are twenty in number, ten in each jaw, consisting of four incisors, two cuspids, — sometimes called canine teeth, also eye-teeth in the upper jaw, and stomach-teeth in the lower, — and four molars, or double teeth. These are developed in the following order between the ages of seven months and two years : At seven months, the two centra] incisors, or front teeth; at eight months, the other two incisors; at one year, the first molars ; at one year and a half, the cus- pids ; at two years, the second molars. See Fig. 122. The Permanent Teeth, — Between six and seven years the permanent teeth, which number thirty-two in all, sixteen in each jaw, begin to appear. The permanent teeth comprise the same teeth as the temporary, with four small molars and two large ones in each jaw in addition. See Fig. 123. The first permanent teeth which appear are the first of the large molars, which come just back of the temporary molars, at about six and one-half years. At seven the central incisors are thrown off'. The other incisors disap¬ pear the eighth year. In the ninth and tenth years the temporary molars give place to the permanent small molars. At twelve the cus¬ pids are changed. During the thirteenth year the second large mo¬ lars appear ; between the seventeenth and twenty-first years the set is made complete by the appearance of the third large molars, or wisdom-teeth. The latter teeth are apt to decay early. The teeth in the lower jaw are generally developed somewhat earlier than those of the upper jaw. The roots of the first set of teeth are absorbed, and probably help to form the second set. It is important that mothers should be familiar with the proper Pi^. 122. The Temporary or Milk Teeth. The cut shows at 1, 2, 3, 4, 5, 6, 7, and 8 the rudiments of the Per¬ manent Teeth. T1IE (ESOPHAGUS. 249 Fig:. 123. The Permanent Teeth. The cnt shows how each tooth is supplied with nerves and blood-vessels from the same nerve trunks and arteries which supply other parts of the face. The (Esophagus. — This organ, commonly called the gullet, or meat-pipe, is a muscular canal about nine inches in length, extending from the back part of the mouth to the left upper portion of the stomach. Its walls contain two layers of muscular fibres, the outer layer running longitudinally, or lengthwise of the tube, the fibres of the other being circular in arrangement. When not in use, the walls of the oesophagus lie in contact, so that there is no opening. At the lower end, the circular fibres are sufficiently thickened to form a sphincter muscle, by means of which the contents of the stomach are prevented from escaping upward. time for development of the several teeth, especially those of the first set, as many of the maladies of children are connected with “ teething,” and may often be prevented by proper attention to the teeth. 250 ANATOMY, PHYSIOLOGY, AND HYGIENE. The Stomach. — This, though one of the most im- portant, is by no means the ( ssential organ of digestion, as was formerly supposed. Contrary to the old view, it is now understood that the stomach is only one of of organs which a series take part in the work of digestion, each of which has an important function to perform, as necessary in its place as that of any other. The stomach may be briefly described as a hollow muscle. It is simply an expansion of the alimentary canal, which in the oesophagus is reduced to a narrow tube, but at the lower extremity of that organ I’ig. 124. The Stomach, with a portion of the Duo¬ denum attached. abruptly expands into a pear-shaped viscus nine to twelve inches in length, and four to five inches in width, in its broadest part. It is capable of holding one to two quarts, but it will allow of consider¬ able distension, so as to be made to hold much more than this quan¬ tity. In early infancy, the stomach is a mere spindle-shaped expansion of the digestive tube ; but as the individual advances in age, it becomes more irregular in shape, its lower border being convex, while its upper is concave in outline, as may be seen by reference to Fig. 124. The walls of the stomach are made up of the outer serous coat, next to which is the muscular coat, made up of three distinct layers, the outer of which, like that of the oesophagus and of the whole ali¬ mentary canal, is longitudinal, the next inner layer being made up of circular fibres, and, in addition, still another set of fibres peculiar to the stomach, running in an oblique direction. Within the muscular coat, and lining the organ, is the mucous membrane, which, in addition to the usual characteristics of a mucous membrane, presents peculiar glandular structures, which have received the name of peptic glands, from the character of their secretion. These glands are tubular in structure, and are found in all parts of the stomach, but most abun¬ dantly in the left, or cardiac end of the stomach, the whole number being estimated at five millions. In the above diagram the position of the stomach will be clearly seen, together with its relation to other internal organs. I. Stomach, partially covered by the liver and lungs; III. Small intestines ; IV. Colon; V. Lower or Sigmoid portion of the colon. / THE STOMACH. 251 Besides its peculiar glands, the gastric mucous membrane con¬ tains a remarkable arrangement of blood and lymphatic vessels designed to produce rapid absorption of liquids received into the stom¬ ach or prepared for absorption by the process of digestion. Cover¬ ing the mucous membrane of the stomach everywhere, and lining its tubular glands, is a layer of living cells, known as epithelial cells, or epithelium. It is to these living, active molecules of life that the vital functions of this organ are chiefly due. By them are formed both the mucus which protects the surface of its delicate membranous lining, and the gastric juice for the solution of the food in gastric di¬ gestion. The epithelium itself also protects the membrane upon which it rests. At the lower end of the stomach is a narrow orifice at which the circular muscular fibres are much thickened, forming a sphincter muscle; this is known as the pylorus, which literally signifies, “gate¬ keeper.” The relative position of the stomach and of the other digestive organs may be readily seen by reference to Plate VII. The Small Intestine. — The pylorus forms the division between the stomach and the small intestine, which constitutes by far the greater portion of the alimentary canal, being about twenty feet in length. Its convoluted form, as seen in the diagram already referred to, is necessitated by its great length, which, together with the several functions which it performs, makes it by far the most important of the different portions of the digestive apparatus. See Fig. 120. That portion of the small intestine joining the stomach is called the duodenum, which is about ten inches in length, and broader than the rest of the small intestine. In structure, the small intestine has the same general plan as that observed in the stomach ; viz., an external serous coat, the peritoneum, then the longitudinal and circular mus¬ cular layers, and an inner lining of mucous membrane with its glands and epithelium. The mucous membrane of the small intestine pre¬ sents a variety of glands, together with peculiar and remarkably well adapted structures for increasing the rapidity of absorption, known as villi. Figs. 125, 126, and 127. The Liver aud Pancreas. — Fig. 128. In close proximity to the duodenal portion of the small intestine are two large glands, the liver and the pancreas, each of which communicates with the intestine by a duct, the two ducts having a common orifice in the mucous membrane of the duodenum, a little more than five inches below the stomach. ANATOMY, PHYSIOLOGY, AND HYGIENE. 9^9 The Colon. — At its lower extremity, the small intestine c o m m u nicates with a greatly expanded p o r - tion of the ali¬ mentary canal, called the colon. The point of junction between these two portions is upon the right side, near the groin, and is guarded by a peculiar structure of the mucous membrane known as the ileo-coscal valve. The colon is about five feet in length. It consists of the ascending, transverse, and descending portions, the last-named part having at its Fig-. 12b. Villi of Intestines slightly magnified. T 1. A Solitary Gland ; 2. Agminated or Clustered Gland. Fig\ 126. The Villi of the intestinal mucous membrane. 14. Artery; 15. Vein; 16. Lactehl Vessels; 17. Lacteal Absorbents ; 18. Venous Absorbents. lower extremity the rectum. The peculiar structure of the colon is such as to well fit it for completing the process of digestion. Like the stomach and the small intestine, the colon has also its muscular and mucous coats, the latter containing various glands, most of which are excretory in character. The position of the colon and of its sev¬ eral portions will be readily seen by reference to Plate VII~ The Digestive Juices.— The apparatus of digestion thus far de¬ scribed is chiefly mechanical in its operation, serving to comminute TEE DIGESTIVE JUICES. 253 Fig. 127. 1. Folds of the intestinal mucous membrane ; ii. Tubular Glands; 3. Mouths of the tubular glands. and transport the food. In some animals, as in some species of birds, this is the most essential part of the work of the stomach. In man and most animals, another class of agents is required ; viz., a variety of fluids capable of reducing to a soluble and liquid condition the several elements of food, thus prepar¬ ing them for absorption. We find these several fluids produced in the human digestive apparatus at the sev¬ eral points where they can accomplish the work required of them in the most efficient manner. They are five in number, and may be briefly described as follows : — Tlie Saliva. — The first of the di¬ gestive fluids is formed by the three pail's of salivary glands located in the vicinity of the mouth and con¬ nected with it by a system of ducts, through which the salivary fluid is conducted into its cavitv. As found in the mouth, the saliva is a mixed secretion, containing, in addition to the products of the three pairs of glands, mucus from the membrane lining the oral cavity. It is a clear, limpid fluid, slightly alkaline in character, and is produced in abundance by frugivorous and herbivorous animals. Carnivorous animals produce it in scanty quantity, having little need for it, as their food rarely contains the par¬ ticular elements which the saliva is designed to aid in digesting. The o o quantity of saliva se¬ creted by the human salivary glands is about three pints in twenty-four hours, of which about one-half is formed during digestion. o o Fig. 128. A. Pancreas; B. Duodenum; C. Spleen. The Gastric Juice. — This is an acid fluid formed only during digestion, by the peptic glands of the stomach. It is produced in great abundance, amounting, in twenty-four hours, to twelve or four¬ teen pints. Its activity as a digestive agent is due to a peculiar 254 ANATOMY, PHYSIOLOGY, AND HYGIENE. principle which it contains, known as 'pepsin, which can be readily- separated from the gastric juice, and can be extracted from the mu¬ cous membrane of the stomach after death. Large quantities of pep¬ sin are manufactured in this way from the stomach of the hog. One firm with which we are acquainted employs for this purpose over three hundred hog stomachs daily. A similar principle is extracted from the lining membrane of the gizzard of fowls ; and an enterpris¬ ing foreigner has recently utilized the stomach of the ostrich for the same purpose. The acidity of the gastric juice seems to be a condition necessary for the efficiency of pepsin, its active principle ; but physiologists have not yet been able to determine the exact nature of the acid to which this property is due. It is most probable that pepsin itself, when existing in its normal organic combination, possesses acid properties. The Pancreatic Juice. — This fluid, which so nearly resembles the saliva that it was once called “ abdominal saliva,” is the product of the pancreatic gland, which resembles the principal salivary glands in structure as closely as does its secretion the salivary secretion. This fluid is secreted only during digestion, and is then produced in considerable quantity, although the amount formed in twenty-four hours, or the quantity necessary for the digestion of a given amount of food, has not been ascertained. Like the saliva, the pancreatic juice is alkaline in character, and has an important office to perform in the digestion of certain of the elements of food. The Bile. — This fluid, usually considered an excretion, also seems to possess certain useful properties as a digestive agent. It is strongly alkaline, of a greenish color and bitter taste, and is produced most abundantly during digestion, although its secretion continues in limited degree during the intervals of digestion. This fact well ac¬ cords with the compound nature of the fluid, it being both a secretion and an excretion, the latter function evidently requiring continuous activity, while as a secretion its activity is demanded only at in¬ tervals. The bile, in company with the pancreatic juice, enters the duode¬ num at a point about five inches below the stomach, so that, contrary to the old views of digestion, the bile is found in the stomach only under very exceptional circumstances. The Intestinal Juice. — This, the most complicated of all the di¬ gestive juices, is the product of the activity of the numerous and THE ELEMENTS OF FOOD. 255 varied glands found in the mucous membrane of the intestines. Being a mixture of the secretion of a number of different glands, the intestinal fluid is of a compound character, which well fits it for its varied functions, as will be seen when we come to consider the physi¬ ology of digestion. THE PHYSIOLOGY OF DIGESTION, The Chemistry of Digestion. — While the numerous and really remarkable changes which take place in digestion are by no means chemical in character, in the sense in which the word is generally understood, yet we may allow the term if we understand that by it is meant, in this connection, not the reactions which take place in dead matter in obedience to the laws of chemical affinity, and which the chem¬ ist can command at will in his laboratory, but a living chemistry, work¬ ing, through the laws of organized or living matter, changes infinitely more wonderful than any chemist can produce, and which he is power¬ less to imitate except through the same agencies. Let it be understood, then, that digestion is not a chemical, but a vital process. Before the process was understood as well as it now is, the changes wrought were supposed to be those of fermentation, to which, indeed, the process is in some degree analogous ; but we now know that fermentation occurs in conjunction with digestion only as an incidental and abnormal — though, unfortunately, a very common — process. The Elements of Food. — A correct understanding of the philos¬ ophy of digestion and its derangements cannot be obtained without a knowledge of the nature of food and of its relation to the digestive organs in general, and to each of the digestive juices. The demand for food is created by the wearing out of the tissues by the vital activities in which they are employed. Every vital action, no matter how slight, is performed at the expense of certain portions of the living tissues. New material is constantly required to supply the want created by this waste. As there is a great diversity in the character of the several tissues of the body, it is necessary that the food should contain a variety of elements in order that each part may be properly nourished and re¬ plenished. Classified according to their relation to the digestive organs, the elements of food may be divided into the following classes : — 1. Farinaceous and saccharine. 2. Albuminous. 3. Fatty. 4. Indigestible. 256 ANATOMY, PHYSIOLOGY, AND HYGIENE. These elements are sometimes found in an isolated state ; but ordi¬ narily they are combined in varying proportions. Nearly all food con¬ tains a larger or smaller proportion of each. For description of the several classes of food, see chapter on ‘‘Food and Dietetics.” Action of the Saliva. — The saliva contains a peculiar organic principle which possesses the property of converting starch into sugar. . This property of the saliva can be studied at will in the following man¬ ner : Place in the mouth a fragment of a dry cracker containing no sugar, or a small portion of well-boiled rice. Now chew it for five min¬ utes. It will be observed that after the first few seconds it begins to have a perceptible sweet taste, which increases as the mastication is con¬ tinued. A quantity of pure starch treated in the same manner will secure the same result. Evidently, sugar is formed during the chewing, as it did not exist in the starch before it was masticated. While under¬ going the process of chewing, the saliva was brought in contact with the starch, and the change noted was effected. Further proof of this change is afforded by the chemist, by means of the chemical test for sugar. If a quantity of starch be submitted to the test referred to, be¬ fore coming in contact with the saliva, it will be found that it contains no sugar. If the same test be applied after the starch has been mixed with saliva for a few moments, an abundance of sugar is found. This experiment we have often made in the presence of an audience, in illus¬ trating lectures on digestion, and with effects clearly visible to all. It should be mentioned that the saliva has the same effect outside of the body as in the mouth, provided that the proper temperature is maintained. It has been recently discovered that most of the fluids of the body possess the power of converting starch into sugar in some degree. It was formerly supposed that the action of the saliva ceased as soon as the food entered the stomach, on account of the presence of the acid of the gastric j uice ; but recent investigations seem to show that this is an error. The secretion of saliva is excited by the presence of food in the mouth, or by any sweet, acid, or other sapid substance. Even the odor of agreeable foods will excite the secretion very strongly. It is also in¬ creased to a considerable extent by the act of chewing, even if the article chewed does not possess either sapid or odorous properties. Action of the Gastric Juice. — After many years of patient study and experimentation, physiologists have at last arrived at a quite accu- ACTION OF TIIE GASTRIC JUICE. 257 rate knowledge of the nature of the gastric juice and of its action upon the food. About the first knowledge gained was by an ingenious ex¬ perimenter who inclosed different kinds of food in small perforated wooden tubes which he swallowed, and afterward vomited. He found that albuminous substances were dissolved in the stomach, so that the wooden tubes containing such foods were vomited empty, while those containing starch and fatty substances remained unchanged. Some years later, a most remarkable opportunity for the study of the gastric juice and its action was afforded by a serious accident suffered by a young Canadian. While hunting, he received in his side the full charge of a gun loaded with buck-shot and fired at the distance of a few yards. An immense rent was made in his body, which exposed not only the lungs but the inside of the stomach. Fortunately, the wounded man fell into the hands of Dr. Beaumont, an unusually intelligent physician, by whose skillful care, together with his own powerful constitution, he was restored to health after many months of suffering and imminent peril to life from the extensive sloughing of the soft parts, with injured ribs and cartilages, being finally left with a large opening through the abdominal wall into the stomach. Through this opening the food was, at first, expelled after each meal, unless retained by a bandage ; but after the lapse of a few months, thoughtful nature drew a membranous curtain before it, when the injured man suffered no further inconven¬ ience, although he could expel food through the opening at will, and often performed the experiment of drinking a cpiart of milk and pouring it out thi'ough the abdominal opening. The accident served to in no way interfere with his general health, and according to late accounts he is still living in Canada, though very old. Dr. Beaumont was not slow to embrace this excellent opportunity for observation and study, and retained St. Martin for several months, and at intervals for a number of years, for the purpose of experiment and investigation. Allowing him to eat various articles, he had but to push aside the little curtain, and the long-studied mystery of stomach- digestion appeared before his eyes, solved by an accident. Dr. Beau¬ mont soon discovered that the principal work of the gastric juice is to dissolve the albuminous elements of food. This conclusion was also proven then, as it has been hundreds of times since, by the fact that a portion of pure gastric juice, collected from the stomach, possesses the property of dissolving albuminous substances, as meat, boiled eggs, the curd of milk, gluten, etc. In repeating the experiment, physiologists 17 258 ANATOMY, PHYSIOLOGY, AND HYGIENE. have purposely produced similar openings in the stomachs of dogs, thus enabling them to collect a quantity of gastric j uice for examination at any time desired. It is even possible to separate from the gastric j uice, or from the mucous membrane of the stomach of various animals , pepsin, the active principle of the gastric juice, and by means of it to experi¬ ment at pleasure upon its digestive properties. The pepsin which can be extracted from the stomach of a healthy dog has been estimated to possess sufficient digestive power to dissolve two hundred pounds of albumen, which would be equivalent to more than two thousand eggs. It has also been observed that the gastric juice of calves, horses, and other herbivorous animals is much less active in digesting animal food than that of carnivorous animals. The secretion of gastric juice is excited by the presence of food in the stomach, especially of semi-solid food, by the presence of the saliva, by sudden alternations of heat and cold, especially by the application of heat. A temperature less than that of the body causes its action to cease ; a slight elevation of temperature increases its activity. Alcohol, alkalies, and tannin antagonize its action, since they precipitate the pep¬ sin and the digested albuminous elements. Bile, which is occasionally forced upward into the stomach, has the same effect. Antiseptics of all sorts, that is, such substances as will prevent fermentation, also interfere with digestion. The metallic salts, as compounds of lead, zinc, iron, cop¬ per, etc., together with compounds of lime, magnesia, and other salts found in hard water, hinder digestion. It has been supposed that acids of all sorts aided digestion, which the¬ ory has led to the frequent recommendation of vinegar and other acids, especially with articles difficult of digestion. This theory has been op¬ posed by those who studied dietetics practically rather than theoretically, and now M. Charles Richet, a distinguished physician of Paris, comes forward with the assertion that he has demonstrated that acetic, tar¬ taric, and all similar acids diminish the secretion of gastric juice while they are in no sense substitutes for it, and so hinder digestion. Action of the Bile. — It has long been well known that the bile is an excrementitious fluid ; but more recent investigations show that it also has an important office to perform in the process of digestion. The alkaline character of the bile enables it to emulsify the fatty elements of food, and by thus permanently dividing it into very small particles, renders possible its absorption. It is probable, also, that the alkaline elements of the bile to some extent saponify the fats, and thus render ACTION OF THE DIGESTIVE JUICES. 259 them soluble in water. An additional office of this digestive fluid is to stimulate the absorption of the digested food, as well as to encourage ac¬ tivity of the intestinal mucous membrane. Deficiency in the quantity of the biliary secretion is a cause of constipation. Action of tlie Pancreatic Juice.— This peculiar digestive fluid is unlike those which have been previously mentioned, in that its action is not confined to a single element of the food. Its office is to digest both starch and fat. It also converts cane-sugar into grape-sugar, or glucose. It thus acts upon two of the three classes of food elements. The most recent experiments on the subject also seem to show that the pancreatic juice has power to act upon the albuminous elements of food, after they have first been acted upon by the gastric juice, so that it really completes the digestion of all the elements, though its chief function is, doubtless, the digestion of starch and fat. It has been shown very recently that removal of the spleen destroys the power of the pan¬ creatic j uice to digest albuminoid food elements. Action of the Intestinal Juice. — This juice, of still more complica¬ ted nature than the pancreatic, digests all three of the classes of digestible foods, acting alike upon the farinaceous, the albuminous, and the fatty elements of food. This complicated function well corresponds with the compound nature of the secretion, it being the mixed product of several glands. It should be remarked, however, that the intestinal juice seems to have little power to dissolve the elements of food unless they have first been acted upon, to some extent at least, by the other digestive juices. Review of the Action of the Digestive Juices. — Having now con¬ sidered in detail the action of each of the digestive j uices, we find that of the five separate fluids, three digest one each of the three classes of digest¬ ible food, while one of the remaining two digests two of the elements, and the other three, or the whole food. Considering the nutritive elements, we find that starch is digested by three separate juices, fats by three, and al¬ buminous elements by two, which would seem to intimate that the di¬ gestion of fats and farinaceous substances is more difficult than that of albuminous elements, a fact which is abundantly confirmed by experi¬ ence in the treatment of disorders of digestion. The Digestive Process. — Before the middle of the last century very little was understood respecting the real nature of the phenomena which together make up the complete process of digestion. Since that time, the subject has been studied so carefully and patiently that physi- 260 ANATOMY , PHYSIOLOGY, AND HYGIENE. ologists have now arrived at a pretty clear understanding of the matter. By far the greatest advances made in this study have been through the aid of several curious accidents by which the human stomach has been exposed to view during life, giving an opportunity for its inspection both when inactive and when in a state of activity from the presence of food. Numerous cases of this nature have been purposely produced in the dog by physiologists for further study, and hundreds of canines have suffered unwilling martyrdom at the shrine of science for the gratifica¬ tion of man’s thirst for knowledge on this subject. Having considered at some length the anatomy of the several di¬ gestive organs, the nature of the various digestive fluids, and the action of each upon the different elements of food, we are now prepared to consider in a connected manner the several processes of digestion. As before remarked, the digestive apparatus consists of a series of organs, of which the stomach is only one, and perhaps not the most important, since life can long be sustained without the activity of the stomach, by alimentation through the lower bowels. In the complete digestive proc¬ ess each one of the series of organs acts successively upon the food ; and the arrangement is such that the prompt and thorough action of each organ is essential to the successful action cf the succeeding ones. In order to simplify the idea of digestion in the mind of the reader, we may remark at this point a fact which is well sustained by the most careful study of the process, that digestion really depends upon two dis¬ tinct vital actions ; viz., secretion and muscular action. The alimentary canal is simply a muscular tube lined with mucous membrane, along which are situated, at different intervals, secreting organs which pour into its cavity their potent juices by means of which the contents of the tube are, if possible, rendered soluble and dissolved. The chief objects of the muscular canal seem to be to move the food along: and bring: it in contact with the active agents of digestion. With this general view of the subject, let us now consider the several steps in the process. In order to form an idea of normal or healthy digestion, let us ob¬ serve the process in a healthy man, in whom all parts of it are purely physiological. He sits down to his breakfast about one hour after ris¬ ing, having taken a little gentle exercise to arouse the activities of the system, and perhaps taken a small quantity of cold water a few min¬ utes before to supply the demand for fluid without taking too much at the meal and to excite the gastric and intestinal secretions, as well as that of the liver, thereby insuring both an active digestion and proper activity of the bowels. STOMACH DIGESTION. 261 Mastication. — Our subject places in his mouth a small variety of foods containing in proper proportion the several elements of nutrition, and simply prepared, without the admixture of stimulating or irritating spices and condiments. As the food is slowly received, it is thoroughly masticated, being ground and triturated by a set of sound teeth, capable of vigorous use, and aided by the salivary secretion, until it is reduced to a pulpy mass. Insalivation. — At the same time that this grinding process is going on, the saliva, while also aiding the mechanical division of the food, is performing its specific work upon the starch of which the food is likely to be largely composed, converting it into sugar, so that the mass of food, or alimentary bolus as it is termed, becomes sweeter in flavor the longer it is chewed. Stomach Digestion. — After thorough mastication, each mouthful of food is in turn swallowed, being drawn down into the stomach by the muscles of the oesophagus, not simply dropping into that organ through an open tube, as many people suppose, the oesophagus being always closed, excepting only that portion which is occupied by the food in its passage to the stomach. Shortly after the food has reached that organ, its mucous membrane assumes, according to the observations of Beau¬ mont on the stomach of Alexis St. Martin, a rosy appearance, and there may be seen oozing from its surface the gastric juice in tiny drops like perspiration on the skin. The secretion increases rapidly, and begins at once its specific action on the albuminous elements of the food, which have been made accessible by thorough mastication, which has broken up the food structures in such a manner as to expose freely all its differ¬ ent elements. It may occur that the gastric .secretion has been excited before the food has been swallowed ; in which case there is no delay whatever in the commencement of gastric digestion. Dr. Beaumont observed, in watching patiently at the curious win¬ dow-like opening in the stomach of St. Martin, that very soon after food is received into the stomach, the muscular structures of that organ be¬ gin to act, setting up a sort of churning process, turning the food over and over, squeezing, pressing, and variously manipulating it, moving it along its lower border toward the pylorus, and returning it along its upper border to the pouch-like left extremity into which it is first re¬ ceived from the oesophagus. If the food contains a large quantity of fluid, this is absorbed be¬ fore the process just described begins, since it is evident that too great 262 ANATOMY, PHYSIOLOGY, AND HYGIENE. an amount of fluid would effectually prevent such action on the food by the muscular walls of the stomach. It is obvious, also, that a con¬ siderable amount of bulk is needed in the food, to enable the stomach to operate upon it effectually. When milk is taken, it is quickly co¬ agulated by the gastric juice, and the whey being absorbed, the gas¬ tric juice acts upon the semi-solid masses formed. Soups, gruels, and all fluid foods, are rendered semi-solid by partial absorption of their watery constituent. At the same time that the gastric juice is acting upon its special elements, the digestion of starch continues through the activity of the mucus of the stomach, the saliva being neutralized by the gastric juice when the food reaches the stomach. Absorption of the portions of the food which are rendered liquid by digestion is all the time taking place, so that the semi-solid character of the mass is in a measure preserved. After this process has continued for a time, which is longer or shorter according to the nature of the food or the manner of its prep¬ aration, portions of food begin to pass out of the stomach. As the mass is moved along the lower border of the stomach toward the py¬ lorus, the orifice is opened a little, instead of being tightly closed as before, and small portions of food which have been properly acted upon by the stomach and the gastric juice, are allowed to pass through. If approached by portions of undigested food, the pylorus contracts strongly and allows none to pass. By this means the food is kept in the stomach until gastric digestion has been well completed. A curi¬ ous fact, however, rather difficult of explanation, is that the pylorus seems to possess a peculiar faculty for discovering whether substances brought in contact with it ought to be digested in the stomach or not. Unbroken seeds, as cherry stones, apple and grape seeds, etc., together with pieces of glass, stone, or other insoluble substances, are allowed to pass without opposition. After a time, the acidity of the food be¬ comes so great from the increase of gastric juice, that the stomach is excited to strong contraction, and the whole mass is crowded through the pylorus into the small intestine, where the work is completed. The length of time intervening between the ingestion of food and the emptying of the stomach varies from an hour or an hour and a half, when the article eaten is boiled rice or a mellow apple, to between five and six hours after eating fat pork or similar food. The figura¬ tive expression used by laborers who claim that pork is an excellent article of food because it “sticks by the rib,” rendered literally, means ABSORPTION. 263 that it is so difficult of digestion that the stomach has hard work to get rid of it after it has been received. Intestinal Digestion. — While stomach digestion has been going on, the gastric juice acting upon the albuminous elements of the food, and the digestion of the starch slowly progressing, the fatty elements of the food have undergone no changes except such as have resulted from the elevated temperature. Being to some extent freed from its association with the other elements, the fat floats upon the surface of the contents of the stomach, when fluid, but undergoes no further change until it comes in contact with the bile and pancreatic juice in the duodenum, when those fluids act upon it in the manner already described. The pancreatic juice also acts vigorously upon the portions of starch remaining undigested, and such portions of cane sugar as may have escaped digestion or absorption in the stomach. W e now have all the elements of food acted upon by the saliva, gastric juice, bile, and pancreatic juice, but, lest any portion should es¬ cape undigested, nature provides the intestinal juice, which continues its action upon all the elements of food alike during the whole of its passage through the small intestine, and perhaps to some extent in the large intestine also. During the process of intestinal digestion the food is slowly moved along through the twenty-five feet of small and large intestines, grad¬ ually becoming more and more solid by the absorption of the portions rendered fluid by the digestive juices, and also gradually being more and more completely deprived of its nutrient elements, until at last there is left in the lower part of the large intestine nothing but the in- nutritious residue of the food, mixed with the excrementitious prod¬ ucts of the intestinal mucous membrane, constituting alvine matter, or feces, which are destined in due time to be discharged from the body, such a discharge occurring normally as often as once in twenty- four hours, in most persons, and usually in the morning before or just after taking breakfast. Absorption. — The process of absorption begins almost as soon as food is taken into the mouth, and continues so long as any soluble nu¬ triment can be extracted from the alimentary mass. The work of ab¬ sorption is performed by two sets of absorbent vessels, minute veins, and lymphatics, here called lacteals. The venous absorbents take up whatever is held in solution, in the fluid taken into the stomach, and the principal portion of the digested farinaceous, saccharine, and albu- 264 ANATOMY, PHYSIOLOGY, AND HYGIENE. minous elements of food. The lacteals (See Fig. 129) absorb the emulsified fats, and some portion of the other elements. The products absorbed by the venous absorbents find their way into the general cir¬ culation through the hepatic vein, after passing through the liver, which is apparently a wise arrangement of nature, to provide for a sort of filtration before the more delicate tissues of the body are exposed to the action of whatever delete¬ rious elements the food may happen to contain. It is claimed by physiologists that the liver has also an impor¬ tant function to perform in completing the work of di¬ gestion, especially that of starchy substances. The food mingled with venous blood is conveyed to the liver by the portal vein. Those products which are ab¬ sorbed by the lacteals, reach the general circulation through the thoracic duct, a long, slender lymph vessel which empties into the large vein from the arm on the left side. Oxygenation. — From the right heart the mixed products of diges¬ tion are sent to the lungs, where, by coming in contact with the oxy¬ gen of the air, the final change is effected, whereby heterogeneous or¬ ganized matter is converted into human blood, with properties and qualities to nourish and repair each of the great variety of delicate tissues found in the body. After the blood has passed through the lungs, neither sugar nor fat, which may abound in the blood before its oxygenation, are found. We have now traced through its various subdivisions the entire process of digestion, and found, until we came to the process of ab¬ sorption, that, as at first remarked, the process chiefly depends on two vital actions ; viz., muscular action, and secretion. Muscular action masticates the food — by the aid of the passive accessory organs, the teeth — and mingles with it the saliva. Muscular contraction draws the alimentary bolus from the mouth down into the stomach. Here, NERVOUS RELATIONS. 2G5 by the action of the muscles, it is churned up with the gastric juice, and finally squeezed through the pylorus into the small intestine, where, by the aid of muscles, it is mixed with the bile and the pancre¬ atic and intestinal juices, and is moved along, constantly coming in contact with fresh secreting and absorbing surfaces, until its digestion is complete. Even absorption is greatly aided by this muscular ac¬ tion, as the circulation in the absorbing parts is thereby quickened, so that larger quantities of fluid are taken up. Nervous Iielatious. — Before leaving the physiology of digestion it should be noted that both the secretion of the digestive fluids and the muscular action of the stomach and intestines are under the control of nerves. The digestive organs are all intimately connected with the general nervous system, so that any change in one is readily noted in the other. A demand for nutriment in the general system is referred to the stomach as hunger, just as the demand for liquor is re¬ ferred to the throat as thirst. Undigested food, or any other obnox¬ ious substances in the stomach, may excite a nausea which will relax and prostrate the whole system. In certain states of the system, and especially in young children, disorder of digestion may even produce convulsions. . On the other hand, we see that agents which affect the general nervous system often influence the digestive organs indirectly with almost the promptness of agents addressed directly to them. The sight or smell of savory viands will “ make the mouth water ” by exciting the salivary secretion. Seeing or smelling disgusting objects will not infrequently cause prompt emesis, when there is nothing whatever in the stomach to occasion vomiting. In a case which came under our observation a few years ago, a gentleman was deprived of several meals by having had the misfortune to meet a very loathsome object. Whenever he attempted to eat, an image of the repulsive ob¬ ject came before his mind, and the immediate nauseating effects were so great as to make it impossible for him to keep anything in his stomach. On more than one occasion a patient has been made to vomit bv being told that he had taken an emetic, when the dose he had swallowed was inert. Vomiting. — This is evidently a result of reflex nervous action in most cases. The exact mechanism of the act we do not need to ex¬ plain, except to say that the expulsive effort is made chiefly by the abdominal muscles and the diaphragm, the stomach taking little active part in the process ; being powerfully compressed against the rigid 266 ANATOMY, PHYSIOLOGY, AND HYGIENE. diaphragm, by the vigorous contraction of the abdominal muscles, its contents are forcibly expelled upward through the oesophagus, contrac¬ tion of the pylorus preventing exit from the stomach in a downward direction. Retching is an effort of the same character as vomiting, only less in degree. Gulping is a peculiar action by which air is drawn down into the stomach. It frequently precedes vomiting, having the effect to relax the sphincter muscle at the lower end of the oesophagus. Other abnormal actions connected with the stomach and bowels will be explained in connection with the diseases of these organs. HYGIENE OF DIGESTION. Probably no part of the vital economy is subjected to so much abuse as the digestive organs. The majority of people eat and drink what their fancy or tastes call for, not once taking into account any possible injury which may result to the stomach from what is put in¬ to it. The stomach is treated like a garbage box, and then is expected to do its duty, or rather to dispose of the indigestible messes imposed upon it promptly and uncomplainingly. If it lags a little in weari¬ ness from overwork, instead of being allowed to rest like any other organ of the body when tired, it is whipped up and goaded on by stimulants in the shape of spices, mustard, pepper, and other condi¬ ments, and often even with wine, beer, ale, brandy, and other artificial means of getting out of an organ more work than it is able to do. The importance of this subject demands serious attention. Its neglect has made the American people a nation of dyspeptics. W e may therefore be justified in devoting considerable space to this topic, and going quite fully into the details of it, so that some practical benefit may be derived from its consideration. From our study of the anatomy and physiology of digestion we have acquired a pretty good knowledge of the principles of the sub¬ ject. Now let us apply these principles, and by so doing we shall be able to discover that many of the most common customs relating to eating and drinking are in direct opposition to the laws of healthy digestion. And first, as one of the most common of all dietetic errors we will mention — • Hasty Eating. — That Americans are everywhere noted for the precipitate manner in which they bolt their meals, tumbling into their DRINKING AT MEAL 8. 2G7 stomachs indiscriminately material that is digestible and indigestible, and spending only enough time to reduce the food to a sufficient degree of fineness to allow it to be swallowed without choking, — often hardly enough for safety in that regard, — is too well known to require special confirmation. The average American eats as he works, recreates, and does everything else, in fact, on the high-pressure system. He treats his mouth like a corn -hopper, and his stomach like a garbage box. The evils resulting from hasty eating may be enumerated as fol¬ lows : — 1. From deficient mastication, the food is not properly divided, so that the digestive juices cannot gain access to its various elements. 2. By being retained in the mouth too short a time, an insufficient amount of saliva is mingled with it, so that salivary digestion cannot be properly performed. As the saliva is also a stimulus to the secre¬ tion of gastric juice, stomach digestion must necessarily be imperfect. 3. Again, the food entering the stomach in a coarse, unmasticated state, may act as a mechanical irritant to the delicate lining of the stomach, and thus occasion congestion and gastric catarrh, one of the most common disorders of the stomach, and one which is often very obstinate in its nature. Drinking at Meals.— In addition to the evils which it occasions di¬ rectly, hasty eating induces an individual to drink largely of hot or cold liquids to wash the food into the stomach. Thus, two evils are as¬ sociated. Liquid of any kind, in large quantity, Is prejudicial to diges¬ tion because it delays the action of the gastric j u ice, weakens its digestive qualities, and overtaxes the absorbents. In case the fluid is hot, if in considerable quantity, it relaxes and weakens the stomach. If it is cold, it checks digestion by cooling the contents of the stomach down to a ■degree at which digestion cannot proceed. Few people are aware how serious a disturbance even a small quantity of cold water, iced cream, or other cold substance, will create when taken into a stomach where food is undergoing digestion. This process cannot be carried on at a temper¬ ature less than that of the body, or about 100’. Dr. Beaumont observed that when Alexis St. Martin drank a glassful of water at the usual tem¬ perature of freshly drawn well-water, the temperature of the food un¬ dergoing digestion fell immediately to 70°, and did not regain the proper temperature until after the lapse of more than half an hour. Of course the eating of very cold food must have a similar effect, making digestion very tardy and slow. If any drink at all is taken, it 268 ANATOMY, PHYSIOLOGY, AND HYGIENE. should be a few minutes before eating, time being allowed for absorption before digestion begins, or an hour or two afterward. If the meal is mostly composed of dry foods, a few sips of warm or moderately hot water will be beneficial rather than otherwise, taken at the beginning of the meal or at its close. The habit of drinking during the meal should be discontinued wholly, and especially by those whose digestive powers are weak. If the diet is of proper quality, and the food is well masti¬ cated, there will be little inclination to eat too much. When the food is rendered fiery and irritating with spices and stimulating condiments, it is no wonder that there is an imperious demand for water or liquid of some kind to allay the irritation. Eating too Frequently. — One of the most pernicious customs of modern society is that of frequent meals. This custom is seen in its ex¬ treme development in England more clearly than in this country, five meals a day, including lunches, being there thought none too many. The idea seems to prevail that the stomach must never be allowed to be¬ come empty under any circumstances. In this country, three meals a day is the general custom, though more are often taken. Healthy di¬ gestion requires at least five hours for its completion, and one hour for rest before another meal is taken. This makes six hours necessary for the disposal of each meal. If food is taken at shorter intervals than this, when ordinary food is eaten, the stomach must suffer disturbance sooner or later, since it will be allowed no time for rest. Again, if a meal is taken before the preceding meal has been di¬ gested and has left the stomach, the portion remaining, from its long ex¬ posure to the influence of warmth and moisture which especially favor fermentation, is likely to undergo that change in spite of the preserving influence of the gastric juice, and thus the whole mass of food will be rendered less fit for the nutrition of the body, and the stomach will be liable to suffer injury from the acids developed. Eating between Meals. — This is a gross breach of the require¬ ments of good digestion. The habit many have of eating fruit, con¬ fectionery, nuts, sweetmeats, etc., between meals, is a certain cause of dyspepsia. No stomach can endure such usage. Those who indulge in this manner usually complain of little appetite, and wonder why they have no relish for their food, strangely overlooking the real cause, and utterly disregarding one of the plainest laws of nature. This evil practice is often begun in early childhood. Indeed, it is too often cultivated by mothers and the would-be friends of little IRREGULARITY OF MEALS. 269 ones, who seek to gratify them by presents of confectionery and other tid-bits of various sorts. Under such a regimen, it is not singular that so many thousands of children annually fall victims to stomach and intestinal diseases of various forms. In great num¬ bers of cases, early indiscretions of this sort are the real causes of fully developed dyspepsia in later years. Irregularity of Meals. — Another cause of this disease, which is closely related to the ones just mentioned, is irregularity respecting the time of meals. The human system seems to form habits, and to be in a great degree dependent upon the performance of its functions in accordance with the habits formed. In respect to digestion this is especially observable. If a meal is taken at a regular hour, the stom¬ ach becomes accustomed to receiving food at that hour, and is prepared for it. If meals are taken irregularly, the stomach is taken by sur¬ prise, so to speak, and is never in that state of readiness in which it should be for the prompt and perfect performance of its work. The habit which many professional and business men have of allowing their business to intrude upon their meal hours, quite frequently either wholly depriving them of a meal or obliging them to take it an hour or two later than the usual time, invariably undermines the best digestion, in time. Every individual ought to consider the hour for meals a sacred one, not to be intruded upon under any ordinary cir¬ cumstances. Eating is a matter of too momentous importance to be interrupted or delayed by ordinary matters of business or conven¬ ience. The habit of regularity in eating should be cultivated early in life. Children should be taught to be regular at their meals and take nothing between meals. This rule applies to infants as well as to older children. The practice of feeding the little one every time it cries is a most serious injury to its weak digestive organs. An in¬ fant’s stomach, though it needs food at more frequent intervals, — two to four hours according to its age, — requires the same regularity which is essential to the maintenance of healthy digestion in older persons. The irregularity usually practiced is undoubtedly one of the greatest causes of the fearful mortality of infants from disorders of the digest¬ ive organs, as appears in our mortuary reports. The subject of infant feeding is a very important one, and on this account we have devoted considerable space to it in the chapter on “Food and Dietetics,” which see. 270 ANATOMY, PHYSIOLOGY, AND HYGIENE. The Proper Number of Meals. — How many meals should be taken by a person in health ? The answer to this question depends somewhat upon the habits of the individual, his occupation, number of hours of labor, etc. There is good reason to believe that for a large share of those who now take three to five meals a day, two> would be much better. According to Hippocrates, the ancient Greeks ate but two meals a day. This was the prevailing custom in oklen times. Indeed, the modern frequency of meals is the outgrowth of a gradual losing sight of the true function of food and of eating, and making the gratification of the palate the chief object, instead of the nourishment of the body. It is distinctly a modern custom. That the system can be well nourished upon two meals a day is beyond controversy, seeing that not only did our vigorous forefathers require but two meals a day, but hundreds of persons in modern times have adopted the same custom without injury, and with most decided ben¬ efit. Students, teachers, clergymen, lawyers, and other literary and professional men, will be especially benefited by this plan. We have employed it for about fifteen years; and with great benefit. The spe¬ cial advantages gained by it are, 1. The stomach is allowed a proper interval for rest ; 2. Sleep is much more recuperative when the stom¬ ach is allowed to rest with the balance of the body ; 8. Digestion can¬ not be well performed during sleep. If six hours are allotted to each meal, and the proper length of time is allowed to elapse before going to sleep after the last meal, it will be found impossible to make any arrangement by which oppor¬ tunity can be secured for the necessary eight hours’ sleep at night. Not more than two meals can be taken when a person complies with all the laws of health. If more than two meals are required by any one, it is by those who are engaged for twelve or more hours per day in severe physical labor. Such persons are better prepared to digest a third meal than those whose occupation is mental or sedentary, and they may at least take it with less detriment, though we are still doubtful whether a third meal is needed, even for such. Eating when Tired.— This is one of the most certain causes of derangement of digestion, and one to which a very large number of cases of dyspepsia may be traced. The third meal of the day is al¬ most always taken when the system is exhausted with the day’s la¬ bor. The whole body is tired, the stomach as well as the rest. The EATING WHEN TIRED. 271 idea that by the taking of food the stomach or any other part of the system will he strengthened, is a mistake. When the stomach “ feels faint and tired ” at night, as many people complain, what it wants is not food, hut rest. An eminent writer on indigestion says very truth¬ fully, “ A tired stomach is a weak stomach.” When the stomach feels “ weak and faint,” rest is what is demanded, and is the only thing that will do it good ; yet many people insist on putting more food into it, thus compelling it to work when it ought to be allowed to remain in¬ active until rested. The arm wearies by constant exercise, and so does the stomach, which is largely composed of muscles as well as the arm. Both secretion and muscular activity must be much lessened in a tired stomach, and the habitual disregard of this rule must be dis¬ astrous to the best digestion. Violent exercise at any time just before or just after eating is in¬ imical to good digestion, for the reason already assigned when the ex¬ ercise is taken just before the meal, and because the vital energies are diverted to other parts — thus robbing the stomach of its necessary share — when the exercise is taken immediately after eating. An English physiologist performed an experiment which well illustrates the truth of this position. Having fed a dog his usual allowance of meat one morning, he took him out upon a fox hunt, and kept him racing over the country until night, when, having killed the animal, he examined his stomach at once and found the meat in the same con¬ dition in which it entered his stomach, no digestion having taken place. In another dog, fed with the same kind of food, but left quiet at home, digestion was found to be complete. The hurry and press of business among Americans is allowed to override every consideration of health. It seems never to enter the thoughts of the average business man that any time is required for digestion. Rushing to his dinner from the plow, the workshop, or the counting-room, he swallows his food with all possible dispatch, and rushes back to his work again, begrudging every moment spent in meeting the requirements of nature. Many years ago, it was a custom in Edinburgh to suspend all business in the middle of the day for two hours, so as to allow ample time for meals. A similar custom once prevailed in Switzerland, we have been informed ; but we presume that such a sensible custom is now considered too old-fashioned to be tolerated. It should be remarked that severe mental labor immediately be¬ fore or after, and especially during meals, is even more injurious than 272 ANATOMY, PHYSIOLOGY, AND HYGIENE. physical employment. The habit many business men have of anx¬ iously scanning the newspapers during their meals and when going to and from their places of business, is a bad one. A full hour, at least, should be taken for the midday meal ; and if an hour’s rest can be se¬ cured before eating, improved digestion would well repay the time spent in re-inforcing the vital energies. For persons of weak diges¬ tion, the rest before eating is in most cases indispensable. The famous L' Homme serpent (man snake), of Paris, who aston¬ ished the world by his agility and wonderful contortions, ate but two meals a day of vegetable food, and invariably abstained from food for twelve hours before performing, a plan which was undoubtedly mutu¬ ally advantageous to his muscles and his stomach, as his exercises re¬ quired great muscular effort. Sleeping after Meals. — While rest from accustomed exercise after eating is important, it should be noted that sleep at this time is equally as bad as vigorous exercise of either mind or body. Good digestion can¬ not take place during sleep. While it is true that digestion is an invol¬ untary act, it should be recollected that it is dependent upon the activ¬ ity of the nervous system for its proper performance. The same nerve which secures activity of the respiratory organs, the pneumogastric, controls the muscular activity of the stomach and intestines. During sleep, from the lessening of nervous activity both the respiration and the circulation are greatly lessened in vigor. It is but reasonable to suppose that the activity of the digestive organs is decreased at the same time, being controlled by the same nerves. Actual experiment shows this to be true. Most people who lie down and sleep an hour or two soon after taking food, awake feeling anything but refreshed. The suspension of the process to a considerable degree during sleep causes imperfect diges¬ tion with its numerous unpleasant symptoms. In the case of old people it may sometimes be beneficial, or at least not harmful, to secure a few minutes’ sleep after eating, before digestion is well begun, but it must not be long continued. In order to secure the best conditions for digestion after eating, an individual should take gentle exercise of some kind, as walking, carriage or horseback riding While violent exertion seriously interrupts the di¬ gestive process, a moderate degree of physical exercise facilitates the process by increasing the muscular activity of the digestive organs and thus encouraging both secretion and absorption. LATE SUPPERS. 273 Late Suppers. — Eating late at night, when the muscular and nerv¬ ous systems are exhausted by the labor of the day, and then retiring soon to rest, is one of the most active dyspepsia-producing habits to which modern society is addicted. As before explained, “ a tired stom¬ ach is a weak stomach ; ” and in addition, we may add, a sleepy stomach is a sluggish one. Secretion must of necessity be deficient in both quan¬ tity and quality, owing to the exhausted condition of the system ; and with the further obstacle afforded to prompt digestion by the slowing of the vital operations during sleep, it is almost impossible that there should be other than disturbed digestion and disturbed sleep in conse¬ quence. It is under these circumstances that people often suffer with obstinate insomnia, bad dreams, nightmare, and similar troubles, from which they arise in the morning unrefreshed, and unrecuperated by Nature’s sweet restorer, the work of assimilation, by which repair takes place, having been prevented by the disturbed condition of the nerves. No food should be taken within three or four hours of retiring. This will allow the stomach time to get the work of digestion forward sufficiently to enable it to be carried on to completion without disturb¬ ance of the rest of the economy. The last meal of the day, if three meals are taken, should be a very light one, preferably consisting of ripe fruit and simple preparations of the grains. The custom which prevails in many of the larger cities of making dinner the last meal of the day, eating of articles the most hearty and difficult of digestion as late as six or even eight o’clock, is one that ought to be discountenanced by physicians. It is only to be tolerated at all by those who convert night into day by late hours of work or recreation, not retiring until near midnight. But in such cases, a double reform is needed, and so there can be no apology offered for this reprehensible practice on any physiological grounds. Too Many Yarieties of Food. — Many dyspepsias arise from the eating of too many kinds of food at the same meal, another growing custom in modern times which deserves to be distinctly condemned. At great dinners in honor of distinguished personages, when friends are to be entertained, and in the majority of well-to-do families as a general custom, the eaters are tempted to gluttony by having presented to their palates a great variety of complicated dishes, almost any one of which would be too much for the digestive organs of most inferior animals. On the occasion of the giving of a great dinner to some notable, we have known instances in which more than a hundred dishes were served in 18 274 ANATOMY, PHYSIOLOGY, AND HYGIENE. successive courses. Such gormandizing soon breaks down the most vig¬ orous digestive organs, since it adds to the labor of digesting food which is improperly cooked, a larger variety than the digestive juices are capa¬ ble of bringing into a fit state for absorption. Careful experiments have shown very clearly that different classes of food require a particular quality of digestive juices for their digestion. For instance, a gastric juice that will digest animal food the best, is inferior for the digestion of vegetable food, and vice versa. The obvious conclusion to be drawn from this fact is that the simpler the dietary, the more perfectly will the digestive process be performed. For persons whose digestive powers are naturally weak this is a matter of special importance. Such wrill find it wTell to avoid eating meat and vegetables together. Meat and grains may be taken together, but not meat and vegetables, by persons of weak digestion, the latter being much more difficult of digestion than either of the others. If the bill of fare taken at a single meal were con- fined to three or four articles of food, there would be fewrer dyspep¬ tics scanning the newspapers for some patent nostrum to “ aid diges¬ tion.” Hot and Cold Bathing after Meals. — Especial mention should be made of the injury to the digestive organs quite certain to result from taking either a hot or a cold bath soon after eating, as few' peo¬ ple are aware of the danger of laying the foundation for years of dis¬ comfort in this wray. If the bath be a hot one, the stomach will be deprived of the blood necessary to support the rapid secretion of gas¬ tric juice for the digestion of the food, by the sudden relaxation of the capillaries and arterioles of the skin, drawing the blood to the sur¬ face of the body. A cold bath, on the other hand, or any sudden ex¬ posure to cold, may, by causing contraction of the blood-vessels of the surface of the body, cause sudden congestion of the stomach, which is equally fatal to good digestion. Very nearly the same danger exists from the taking of baths just before a meal. The practice very common among boys and young men, of going into the water in the summer time regardless of the condition of the stomach or of other states of the body, is a bad one. With many it is a very usual practice two or three times a week if not more often, to go at once into the water after the evening meal, not allow'ing even time for the work of digestion to become established. No bath in¬ volving any considerable portion of the body should be taken within two hours of a meal. OVEREATING. 275 Errors in Quantity of Food. — If errors in the manner of taking food are active causes of indigestion, mistakes in quantity are still more potent in this direction. It should be noted, however, that er¬ rors of this class are very closely connected with errors in the manner of eating, and in the quality of food taken. It is generally true with physical as well as moral transgression, that one bad habit implies an¬ other; and especially is this the case in reference to dietetic errors. A person who eats too fast is likely to eat more than is necessary ; and the same is true if too large a variety of food is partaken of, or food rendered exciting and stimulating by seasoning with irritating condiments. Overeating. — Intemperance in eating is, in our opinion, responsi¬ ble for a greater amount of evil in the world than intemperance in drinking. We do not fear to make this statement, since we believe it can be clearly shown that intemperate eating is, in the first place, one of the most potent causes of intemperance in drinking, and, secondly, that it is one of the greatest obstacles in the way of the reformation of those who have become victims of alcoholic intemperance. If we may believe the statements of historians, gluttony is by no means a modern vice. Indeed, there is quite good ground for believ¬ ing that overeating, while a very general fault, is rarely if ever car¬ ried to the enormous excess to which some of the luxurious Roman emperors indulged, as for instance, the Emperor Maximus, who con¬ sumed forty pounds of flesh in a day ; or Caligula, whose custom was to eat until compelled to desist from having distended his stomach to its utmost capacity, and then taking an emetic to enable him to re¬ peat his gormandizing. The evil consequences of excess in eating are at first simply im¬ perfect digestion, the overtaxed organs being unable to accomplish the complete digestion of the alimentary mass. In consequence of the delay which occurs, changes take place by which acids are devel¬ oped which irritate the mucous membrane, together with gases by which the stomach is distended and its muscular walls weakened and partially paralyzed. In course of time, inflammation of the gastric membrane is developed, and permanent dilatation of the stomach occurs. At first, an individual who overeats will be likely to accumulate flesh quite rapidly ; but very soon the digestion becomes so much dis¬ turbed that no gain takes place, and, indeed, the patient not infre- 276 ANATOMY, PHYSIOLOGY, AND HYGIENE. quently becomes considerably emaciated even while daily taking large quantities of food. When the opposite is the case, the blood is filled with crude, imperfectly elaborated material, which, when assimilated, produces a poor quality of tissue. Eating too Little. — A far less common fault than that last men¬ tioned, is eating too little. The instances that occur are usually in the cases of those who have attempted to subject themselves to a rigid dietetic regimen for the prevention or cure of disease, and who, from having only a partial view of the subject, entertain extreme notions. By the weakening of the system which necessarily occurs when an insufficient amount of nutriment is received, the stomach also becomes weak and debilitated, its secretions and muscular efforts being greatly impaired in both quantity and quality. This is well seen in persons who have been long deprived of food. When allowed to eat, they are unable to digest but the smallest quantity of food ; and though the system is famishing for nourishment, an amount of food equal to that taken at an ordinary meal would be almost as fatal as a dose of strychnia. How Much Should a Person Eat 1— Hundreds of times have we been asked this question ; but we have never been able to give any other answer than might be suggested bv the common sense of the questioner, without medical assistance. The only reply that can be made to this question is, just so much as the system needs and the digestive organs can digest. In general, an individual may take as much food as he can digest ; but often there are conditions in which he cannot digest as much as he really needs. For instance, when an individual is called upon to exert all his energies of brain and muscle, to strain every nerve to its utmost to compass a certain object of great importance, to cope with an emergency, he may be for the time being quite unable to digest sufficient food to make good the waste that must necessarily occur. He will lose flesh and strength under such circumstances ; and often a failure of the appetite at such a crisis indicates the inability of the stomach to digest, from the deficient se¬ cretion of gastric juice. It is on this account that persons who are for a time called upon to make great exertions often break down their digestion. Thinking that they need abundance of nutriment, which is true, they eat as heartily as when required to perform only their ordinary work, not considering their diminished power to digest QUANTITY OF FOOD REQUIRED. 277 and appropriate food, and in a short time find their digestive organs unable to digest well even a small amount of food. We are satisfied that it is in this way that many lawyers, physi¬ cians, and other professional men, break down. If, when called upon to do a large amount of extra work, the individual would lessen the quantity of food eaten, instead of increasing it, he would conserve his vital forces much more than by pursuing the opposite course. When required by the press of business to do extra work, often working for several days in succession with very little sleep, we have been in the habit for several years of limiting the amount of food taken to not more than half the usual allowance, and sometimes to even a less quantity. The result has invariably been all that could be desired ; since, although we have often lost several pounds of flesh during an ordeal of this kind, when it is past, and we return to our usual routine of work, we bring back from the effort our digestion intact, and are able to digest the amount of food necessary for recuperation, so that a few days suffice to restore us to our usual weight, and with¬ out loss of either strength or time. It is evident that the diet of each individual must be regulated in quantity according to his occupation. It must also be adapted to his age. A man engaged in severe physical labor, while he really re¬ quires less food, may be able to dispose of more food than one who labors with equal intensity in some mental pursuit. The body is wasted much more rapidly by vigorous brain labor than by physical exercise. Indeed, it is asserted by our best authorities in physiology, that three hours of severe brain labor are equal in exhausting effects upon the system to ten hours of physical labor or muscular effort. It is evident, then, that a man who works his brain constantly for ten or twelve hours a day really needs more food to sustain his strength than a man who employs his muscles for the same length of time. But, as before remarked, the muscle laborer may be able to dispose of more food than the brain laborer, though he needs less, since his vital forces are not so completely exhausted by his work. In other words, the occupation of the muscle worker being less exhaustive than that of the brain worker, he can overeat with greater impunity than can the latter. Each should eat but the quantity actually required, if he would enjoy the maximum of health and vigor ; but for the man whose vital energies are daily exhausted by mental effort, any excess in eating is certain to be most disastrous. We have examples of great 278 ANATOMY, PHYSIOLOGY, AND HYGIENE. literary men who have been great eaters ; but it is a noticeable fact that these persons, in many instances, while celebrated for their pro¬ ductions, often worked very leisurely, their fame being really more justly attributable to brilliant genius than to great application. In several cases, too, as in that of Charles Dickens, who is said to have been a large eater, the hours spent in brain labor were chosen from the best of the day, many hours being spent in physical exercise, by which means the integrity of the digestive organs was maintained much better than would otherwise have been the case. In not a few instances, too, those great literary men who were noted eaters died early, their physical stamina being exhausted by the double draft made upon it. Newton, when engaged in the most severe portion of his wonderful labors in demonstrating the law of gravitation by com¬ putations respecting the orbit of the moon, confined himself to a spare diet of bread and water. The amount of food required by an individual, as already inti¬ mated, varies at different periods of life, according to the degree of vital activity. In infancy and childhood, when the vital activities are at their highest degree of intensity, when growth and develop¬ ment are to be maintained in addition to supporting the wastes of the system, the demand for food is greater in proportion to the size of the individual than at any subsequent time. In adult life, when waste and repair are about equally balanced, a sufficient amount is needed to make good the daily loss from the various mental, physical, and other vital activities, which can only be supported at the expense of tissue. Any larger quantity than this is excess. In old age, when the assimilative powers are weakened by declin¬ ing years, the amount of food which can be assimilated by the indi¬ vidual is even somewhat less than what is really needed ; hence, as age advances, the quantity of food should be gradually diminished. Very many old people break down much sooner than they would otherwise do were they more careful in this regard. When they lay aside their vigorous, active life, they should also curtail the quantity of their food. By this act of temperance, they might preserve intact to a much later period the integrity of their digestive organs, and so add years to their lives. In not a few instances, the foundation of dyspepsia is laid by some mechanical injury, as a sprained ankle, a broken limb, or a se¬ vere bruise or cut, which requires rest from active exercise for a few QUANTITY OF FOOD REQUIRED. 279 weeks. Not considering the fact that much less food is demanded when an individual is not engaged in active labor of any sort than at other times, the individual continues to eat heartily, and soon finds, that, from sheer exhaustion, the digestive organs refuse to do their work. On this account it should he made a uniform custom to eat lightly on the weekly rest-day. The hearty Sunday dinners in which many people indulge, making the day an occasion of feasting rather than a rest-day, cannot be too much condemned. The custom is without doubt responsible for many other forms of Sabbath-breaking, as no individual can have a clear perception of right and a quick sense of wrong when laboring under the incubus of an overloaded stomach. For the hearty meal usually taken, it would be well to substitute a light one consisting mostly of fruits and grains. This plan, if pur¬ sued, would do away with much of the drowsiness in church, of which many people and not a few pastors have abundant reason to complain. The intellect would be much clearer, and so better able to appreciate the privileges and comforts of religion. The sooner people recognize the fact that stomachs have much to do with religion, and that true religion includes the government of the appetite, and frowns upon abuse of the stomach as well as upon abuse of a fellow-man, the bet¬ ter it will be for both their stomachs and their religion. We are not sure but that many gloomy theological dogmas were born of bad stomachs and inactive livers ; and we are very certain that one of the best preliminary steps toward converting a sinner is to reform his stomach. Each individual must be to a considerable extent his own guide respecting the exact amount of food to be taken at a single meal. If the appetite has been so long abused that it is no longer a safe guide, then reason must rule. The individual should, at the beginning of the meal, determine just how much he will eat, and when the spec¬ ified quantity is taken, he must resolutely stop eating, leaving the table if necessary, to escape temptation. The practice of serving fruit, puddings, nuts, confectionery, and tidbits of various kinds, as “ dessert,” is a pernicious one. In the first place, it is an inducement to overeat, since it is quite probable that enough has been eaten be¬ fore the dessert is served. If the articles offered are wholesome, they should be served and eaten with the meal, as a part of it, and not at its close, in addition to the meal. Furthermore, it is generally the case that most of the articles served at dessert are wholly unfit to 280 ANATOMY , PHYSIOLOGY, AND HYGIENE. be eaten at any time, and so should be discarded. Dessert is really an ingenious device to induce people to make dyspeptics of them¬ selves by eating more than they need. A man who desires to be at peace with his stomach should learn to “ stop when he has enough,” no matter how strongly he may be tempted to do otherwise. There is much more truth than poetry in the old Scandinavian proverb, “ Oxen know when to go home from grazing ; but a fool never knows his stomach’s measure.” But experience, a dear school, ought after a time to teach the most unobserving person the amount of food his stomach will bear without discomfort, and without injury. If a person in fair health finds that after eating of whole¬ some food, he is troubled with fullness of the stomach, dullness over the eyes, “ sour-stomach,” eructations, or flatulence, he may be very sure that he is eating too much, and he should continue to diminish the amount taken at each meal until the symptoms mentioned disappear. By reference to the table given on page 870, it will be possible to ascertain with ease the amount of nutriment consumed in any given quantity of different varieties of food. It is worthy of remark that the grains, as shown in the table above mentioned, are by far the most nutritious of all the various classes of food. It will be observed, for instance, that oatmeal, Indian meal, and peas contain three times as much real nutriment as lean beef. When economy must be considered in the selection of food, this is a very important consideration. This becomes doubly evident when we consider that it takes eleven pounds of vegetable food, including Indian meal, dry hay, etc., to make one of beef. Thus it appears that as nutriment one pound of oatmeal at first¬ hand is as valuable as thirty or more pounds taken at second-hand, through the medium of beefsteak. Deficient Food Elements. — While the food may be abundant in gross quantity, it may be deficient in some one or more of the various important elements which go to make up the food. If the food is defi¬ cient in farinaceous and fatty elements, the individual will soon show signs of suffering in consequence. A lack of the nitrogenous elements will occasion still more marked effects, the stomach losing its tone and vigor, giving rise to acidity, flatulency, and various associated disturb¬ ances. The deficiency of the coarser, innutritious elements of the food, is also very soon felt by diminished activity of the stomach and bowels, both in secretion and in muscular action. Hence the great importance of choosing carefully and judiciously the articles of food to be taken, es- DEFICIENT FOOD ELEMENTS. 281 pecially when a regular dietary is to be followed. Such a selection should be made as Avill supply to the system all the elements of nutrition in proper quantity. To employ a dietary in which any one of the nu¬ tritive elements is deficient, although the quantity of the food may be all that the digestive organs can digest, is as really starvation, and will as certainly occasion the same results ultimately, as total deprivation of food. To attempt to live on white bread and butter and strong tea or coffee, is as certain to impoverish the blood as refraining from eating al¬ together, the only difference being in the length of time required to bring about the result. Thousands of pale-faced, ansemic, thin-blooded, nerveless, dyspeptic women owe all their troubles to an impoverished diet. Tea drunkenness, in which an individual attempts to subsist on the Chinese herb almost wholly, is a not uncommon thing ; and in consequence of its pernicious influence, the sagacious physician not infrequently finds as well marked cases of scurvy among ladies of the higher classes of so¬ ciety as among the poorly fed sailors of the whaling vessel after a long voyage with prolonged confinement to a monotonous saline diet. Young ladies who attempt to exist with little other food than tea, pastry, and confectionery, need not wonder that they grow to be lank and sallow and hollow-eyed dyspeptics. Under such a regimen, the most hardy quadruped would succumb. Many parents weaken the digestive organs of their little ones for life by feeding them when very young upon such insufficient diet as corn-starch or arrowroot gruel, and similar preparations, and when they become older, upon fine-flour bread. Repeated experiment has shown that a dog will die of starvation in a month when fed upon white or fine-flour bread alone. Fed upon bread made of the whole grain, or graham bread, dogs as well as other animals suffer no deterioration in weight or in strength. The difference between fine flour and graham flour is largely in the proportion of gluten which they contain. Fine flour is made from the innermost portion of the grain, which is almost pure starch, thus excluding the brain, nerve, and muscle nourishing ele¬ ments which are found chiefly in the portions of the kernel that lie next the outer husk. Whole-wheat flour also contains portions of inriu- tritious matter which, under most conditions, are advantageous, encour¬ aging both secretion and muscular activity of the bowels, and thus pre¬ venting constipation, which is often a forerunner of more serious disease of the digestive organs. There are cases in which the coarser portions of the bran are inj urious by causing irritation ; but these cases do not often occur. 282 ANATOMY, PHYSIOLOGY, AND HYGIENE. While it is necessary to have all of the elements of the food in proper proportion, it is of first importance that the nitrogenous ele¬ ments should be sufficient in quantity, even if it should be necessary to take an excess of the farinaceous elements to secure the proper amount, since it is of these elements that the vital portions of the body are formed. By reference to the table given on page 880 it may be ascer¬ tained what quantity must be taken of the different kinds of food in or¬ der to obtain a sufficient supply of nitrogenous elements. The Quality of Food. — Man, like other animals, is made of what he eats ; hence the German proverb is literally true, that “ as a man eateth, so is he,” and we may well credit the assertion of an eminent au¬ thor that the general tendency of thought in any nation may be deter¬ mined by the character of the national diet. True as this principle is when applied to the body in general, it is especially true as referring to the stomach. No organ is so directly and so profoundly affected by the quality of the food as the stomach. Bad Cookery.— The real object of cooking is to render the ele¬ ments of food more digestible. It is intended, indeed, to be a sort of partial preliminary digestion of the food ; but the numerous devices of cooks and caterers, — complex compounds and indigestible mixtures, — have so far subverted the original design of the process as to render cooking a means of making food indigestible as often as otherwise. Altogether too little attention is paid to the subject of cookery as a science. In the majority of cases the task of preparing food for the palate — the stomach is seldom thought of — is intrusted to ignorant servant girls or colored cooks who compound mixtures by “ the rule of thumb,” and without any reference whatever to the physiological wants of the body. We are glad to see a slight indication of reform in this direction in the establishment of schools of cookery in the larger cities, and lectureships on the subject in some of our female seminaries. To become a good cook requires as much native genius and far more prac¬ tical experience than to become a musician or a school-teacher, or even to enter some of the learned professions. The position of cook ought to be made so respectable and lucrative that it will attract persons of sufficient mental capacity and culture to make the art subservient to the purposes for which it was first employed and designed. A poor cook in a family is a worse enemy to the health, the comfort, and even the morals of the household, than would be a swamp generating malaria a half-mile away, a cesspool fever-nest at the back door, small-pox across the street, or a Chinese Joss-house in the next block. INJURIOUS FOODS. 283 Fried Food .—Of all dietetic abominations for which bad cookery is responsible, fried dishes are the most pernicious. Meats, fried, fricasseed, or otherwise cooked in fat, fried bread, fried vegetables, doughnuts, griddle-cakes, and all similar combinations of melted fat with other elements of food, are most difficult articles of digestion. None but the most stalwart stomach can master such indigestibles. The gastric juice has little more action upon fats than water. Hence, a portion of meat or other food saturated with fat is as completely protected from the action of the gastric juice as is a foot within a well-oiled boot from the snow and water outside. It is marvelous indeed that any stomach, under any circumstances, can digest such food, and it is far from remarkable that many stomachs after a time rebel. It is principally for this same reason that “ rich ” cake, “ shortened ” pie-crust, and pastry generally, as wrell as warm bread and butter, so notoriously disagree with weak stomachs, and are the efficient cause in producing disease of the digestive organs. The digestion of the food being interfered with by its covering of fat, fermentation takes place. The changes occasioned in the fat develop in the stomach ex¬ tremely irritating and injurious acids, which irritate the mucous mem¬ brane of the stomach, causing congestion, and sometimes even inflam¬ mation. Uncooked Food. — Raw food, and food which is insufficiently cooked, is a frequent cause of indigestion. This is especially true of uncooked vegetables. Man is naturally a frugivorous animal, and is able to make use of vegetables and many grains as food only by the aid of cookery. The starch of vegetables is much more difficult of digestion than is that of fruits. All starch, in fact, is much easier of digestion if subjected to the action of heat before being eaten. By the action of heat, the starch granules, which consist of the starch proper inclosed in little capsules, are ruptured, and thus the digestive juices can readily come in contact With and digest the starch. When starchy substances are eaten raw, extra work is laid upon the organs of di¬ gestion, and indigestion follows. It is for this reason that raw fruit and green vegetables occasion so much disturbance of the stomach and bowffis, these immature foods containing large quantities of starch in a very indigestible state. By cooking, unripe fruit and vegetables may be in a great degree deprived of their injurious properties. In Scotland, the eating of oatmeal imperfectly cooked is a very common 284 ANATOMY , PHYSIOLOGY, AND HYGIENE. practice, the result of which is an almost universal suffering from a peculiar form of indigestion due to it. Nearly all kinds of food are much more easy of digestion after cooking than before, providing the cooking is performed in the proper manner. For vegetables and grains, cooking is especially necessary. Decayed Food. — Much harm comes from eating food which has made appreciable advancement in the direction of decay. This is true of both vegetable and animal food. By the process of decomposition, poisonous elements are developed in animal and vegetable substances which do not naturally exist there. If decomposition is far advanced, these poisons may exist in such quantity as to produce immediate ill effects, sometimes occasioning death in a few hours. Instances of this sort have often occurred from eating canned meats which had spoiled, or which had been kept for a short time after opening. The practice in vogue in some countries, and to some extent in this, of keeping meat for some days before eating, so as to give it tenderness and a “ high ” flavor, is a most pernicious one. Better far, for health, is the horrible Abyssinian custom of eating the flesh while still warm and quivering. For persons with slow digestion, such food is especially bad, since di¬ gestion is so slow that decomposition is not corrected, as it is to some extent in a healthy stomach, by the gastric juice, but is allowed to con¬ tinue with all its serious consequences. If no immediate effects are seen to follow the use of such food, the poisons generated may be absorbed and appear hi some later form analogous to blood poisoning. The stom¬ ach of a hyena may be able to digest the putrid flesh of a decaying carcass ; but man’s stomach was not intended for scavenger use, and re¬ quires fresh, untainted food. Soft Food. — The structure of man’s teeth indicates that he was in¬ tended to employ a diet consisting of food with sufficient consistency to require vigorous mastication. His jaws are armed with thirty -two strong teeth, compactly arranged in his mouth in such a manner as to make them most available for use. Obeying the general law governing all organized structures, by which organs develop or degenerate accord¬ ing as they are used or allowed to remain inactive, the teeth retain their health if vigorously employed in the mastication of solid food, but rap¬ idly undergo decay when not thus used. This is well seen in cows which are fed on “ distillery slops.” The teeth of such animals decay and drop out for want of use, while those of cattle which keep their teeth actively employed in chewing the cud, are preserved intact. The same is true of EXCESSIVE USE OF SUGAR AND FATS. 285 human beings. Eating soups, gruels, and other soft food, to the exclu¬ sion of articles requiring mastication, ruins the teeth at the same time that it disorders the stomach through the taking of too much fluid, and deficient insalivation. Too Abundant Use of Fats. — Unfortunately for the poor stom¬ ach, the opinion prevails almost everywhere that food made “ rich ” with fat is the most nourishing. Undoubtedly, fat is an element of nutrition, and can be digested and assimilated when taken in proper quantities and in a proper manner ; but the excessive use of fats of various kinds — lard, suet, butter, and other animal and vegetable fats or oils — is a prolific cause of certain forms of indigestion, especially that known as bilious dyspepsia. Eminent physiologists determined by careful experiment many years ago the fact that the large use of fats greatly lessens the biliary secretion, the quantity of bile be¬ ing diminished in some instances to a very small fraction of the amount secreted when only pure water or food containing little fat was taken. When it is remembered that the bile is an essential ele¬ ment for the digestion of fat, it will be seen that a diminution of this digestive fluid, in connection with the taking of an extra quantity of oleaginous matter, is a most unfortunate circumstance, since it is thus absent when most needed. This fact sufficiently well accounts for the distressing symptoms which accompany the excessive use of fats by those whose digestion has been already weakened by abuse of this sort. The diminished quantity of bile eliminated by the liver is also sufficient cause for the condition established by the over-use of fats, vulgarly known by the expressive term, “bilious.” The elements which ought to be eliminated from the system are retained, clogging the vital machinery, and giving rise to the many unpleasant symp¬ toms enumerated hereafter in describing “ bilious dyspepsia.” If fats are to be used at all, it is much preferable to employ them cold, as butter taken on bread at the table, rather than cooked in the food, by which the fat elements permeate and render difficult of di¬ gestion the whole mass of food. The Use of Sugar in Excess. — While sugar, like fat, is a true alimentary principle, capable of aiding in the maintenance of life when employed with the other elements of food, used in excess it be¬ comes a serious source of disease. Employed alone, it is utterly inca¬ pable of supporting the vital activities of the body, being, in this re¬ spect, analogous to starch, its food equivalent. The popular idea that 286 ANATOMY, PHYSIOLOGY, AND HYGIENE. sugar nourishes the nerves or the brain, makes the teeth sound, and is both harmless and wholesome, is quite a mistake, as many an inno¬ cent little one whose fond parents shared in the general error, has found out to the regret and sorrow of his friends. The different forms of sugar, molasses, sirup, treale, honey, etc., are essentially the same in their effects, except that molasses and honey sometimes contain peculiar elements which to some persons seem to be almost active poisons. This is especially true of honey. The injury from the use of sugar, or other saccharine substances, is occasioned, first, by the readiness with which it undergoes fermen¬ tation when subjected to warmth and moisture. In the stomach it finds all the conditions necessary for inducing fermentation ; and were it not that saccharine substances in solution are usually so quickly ab¬ sorbed that it is difficult for the chemist even to detect their presence in the stomach, this change would always occur. When a larger quantity is taken than can be absorbed promptly, or when taken in such form as to make ready absorption impossible, as in the form of preserves and sweet-meats of various sorts, acid fermentation does oc¬ cur, and with serious results not only to the stomach, but to the whole system. The fermentation set up not only develops acids and gases from the sugar, but, being communicated to the other elements of the food, — the starch, and especially the fatty elements, — still worse forms of fermentation or decomposition occur, and the food is thus rendered unfit to nourish the body, while the mucous membrane of the stomach and intestines is irritated by the contact of unnatural, corroding elements in the food; and through their absorption, the whole system becomes affected. The excessive use of sugar also greatly overtaxes the liver, which has an important part to act in its digestion, distracting it from its legitimate function, and thus leaving the elements which it ought to eliminate, to accumulate in the system. Thus an individual may be¬ come “ bilious ” from the over-use of sugar as well as from excess in the use of fats. Condiments. — By condiments are meant all substances added to food for the mere purpose of rendering it more palatable, though pos¬ sessing no positive nutritive value in themselves. Mustard, vinegar, pepper, cinnamon, and various other spices, are included in this cat- egory, together with salt, although the last-named article is by some held to be of the nature of a food, supposing it to supply some want in the body. CONDIMENTS. 287 Mustard, pepper, pepper-sauce, cinnamon, cloves, cardamoms, and similar substances, are of an irritating, stimulating character, and work a twofold injury upon the stomach. By contact, they irritate the mucous membrane, causing congestion and diminished secretion of gastric juice when taken in any but quite small quantities. This fact was demonstrated by the observations of Dr. Beaumont upon St. Martin. After several years’ careful study of the relations of various foods, drinks, etc., to the stomach. Dr. Beaumont stated in summing- up his experiments that “stimulating condiments are injurious to the healthy stomach.” He often saw congestion produced in the mucous membrane of St. Martin’s stomach by eating food containing mustard, pepper, and similar condiments. When taken in quantities so small as to occasion no considerable irritation of the mucous membrane, condiments may still work injury by their stimulating effects, when long continued. The stomach, being at first excited to more than natural activity, afterward suffers from reaction, and is left in an inactive, diseased state, incapable of secret¬ ing sufficient gastric juice to supply the needs of the system in digest¬ ing food. This final result is often averted for some time by increas¬ ing the quantity of the artificial stimulus, in the form of pepper, mus¬ tard, salt, etc., but nature gives way at last, and chronic disease is the result. In the case of salt, there are several further objections to be urged, which are at least cogent against its excessive use ; and by excessive use we mean a quantity which causes thirst either at or after meals, occasioned by the feverish state of the stomach induced by the caustic properties of the saline element. 1. Salt is antiseptic. As already seen, anything which prevents fermentation will interfere with the action of the gastric juice. Hence salt, in any except very small quantities, must materially inter¬ fere with digestion. 2. It is an irritant, not only to the stomach but to other parts of the system as well, as is indicated by the quickened pulse, thirst, and other symptoms of a febrile character experienced by a person after taking a slightly larger quantity than usual. 3. Being a purely mineral substance, in no degree prepared, by as¬ sociation with organized life in plants, for assimilation as is necessary in the case of all mineral substances, it is exceedingly doubtful whether it is a food in the sense that fruit, vegetables, grains, or their 288 ANATOMY , PHYSIOLOGY, AND HYGIENE. several nutritive elements, are foods, and whether it can be assimilated or made to take part in the vital processes of the body in any way, in larger quantities than it is found in food. 4. Experimental evidence shows that human beings, as well as an¬ imals of all classes, live and thrive as well without salt as with it, other conditions being equally favorable. This statement is made with a full knowledge of counter arguments and experiments, and with abundant testimony to support the position taken. We may, in conclusion, remark that though we do not, except in rare instances, advise the entire discontinuance of the use of salt, on account of its having been so long employed as an ingredient of food, we believe that it may be greatly reduced in quantity by all who use it, without detriment, and with real benefit. The manner in which it is treated by the system, being retained in the blood instead of being deposited in the solid tissues to any extent, and washed out through the skin, mucous membrane, kidneys, and liver, and thus rapidly eliminated in proportion to the quantity taken, is at least a hint that a very large amount is not needed. Salted food is generally known to be very hard of digestion, and when it is taken for a long time, the stomach often fails. A piece of fresh fish which will digest well in one hour and a half, requires four hours after salting, according to Dr. Beaumont. Pickles. — Cucumbers, peaches, green tomatoes, and numerous other fruits and vegetables, are sometimes preserved by saturation with strong vinegar. Sometimes whisky or some other alcoholic liquor is added to increase the preservative property of vinegar. The same process which makes it impossible for a fruit or vegetable to ferment or decay, makes its digestion equally difficult, as already ex¬ plained. Pickles are exceedingly unwholesome as articles of food, and often cause acute dyspepsia in those who eat of them. Young ladies addicted to the free use of pickles may be assured that they must certainly part with their favorite dainty or bid farewell to good di¬ gestion. Cucumbers preserved with salt or vinegar are next to im¬ possible of digestion. The proverbial unhealthfulness of this vegetable is a popular notion based .on experience with the article prepared with vinegar and salt. Those chemical agents harden the delicate struct¬ ures of the vegetable, and render it almost unapproachable by the digestive juices. The pure vegetable, unsophisticated by condiments, is as harmless as other green vegetables. We would not hesitate to eat it freely thus, if need be, and in “ cholera times.” TEA AND COFFEE. 289 Yinegar. — As the use of vinegar is continually increasing, atten¬ tion should he called to the fact that it may be a cause of disease. Ordinary vinegar contains about five per cent of acetic acid, its prin¬ cipal ingredient. Like alcoholic liquors, vinegar is a product of fer¬ mentation, being the result of carrying a little farther the same proc¬ ess by which alcohol is produced. Yinegar is much more irritating to the digestive organs than an alcoholic liquor of the same strength. It is extremely debilitating to the stomach when much used, though for the time being exciting. Yinegar is not infrequently employed in considerable quantities by young ladies who are anxious to look pale and interesting, and it never fails to produce the desired effect. It can be well recommended for such a purpose, since it so greatly impairs the digestion as to soon interfere seriously with nutrition. The moderate use of a light wine or of ale or beer is much less de¬ structive to the digestive organs than the large use of vinegar which is not uncommon among hearty eaters. There is really no need of resorting to so inferior a source for a mild acid, as we have the want met most perfectly in lemons, limes, citrons, and other acid fruits. As a dressing for some kinds of vegetable food, lemon juice is a per¬ fect substitute for vinegar. We have maintained this position respecting the use of vinegar for several years, notwithstanding it has been highly recommended by not a few eminent writers on food and dietetics. Yery recently, however, M. Richet, at the head of an august body of French savants, comes for¬ ward maintaining that by careful experiment he has proved that these things are “ bad food for the stomach.” He does not hesitate to pro¬ nounce vinegar and tartaric acid prolific causes of dyspepsia, and highly condemns the use of vinegar and pickles by young ladies. It is no wonder that young ladies who indulge in these unwholesome articles of food grow “ pale and interesting ” with dyspepsia. According to M. Richet, the use of acetic and tartaric acids causes a decrease in the secre¬ tion of gastric j uice, without which no digestion can take place. Tea and Coffee. — In classing these favorite beverages with causes of dyspepsia, we shall certainly call forth a loud protest from the numer¬ ous devotees of “ the fragrant cup and among the number of those who argue for their use we shall find numerous learned professors, as well as nearly the whole sisterhood of the wives, maidens, mothers, and grandmothers of the nation, along with a good proportion of the hus¬ bands, fathers, brothers, and grandfathers as well. Nevertheless, it can 19 290 ANATOMY, PHYSIOLOGY, AND HYGIENE. be easily shown that whatever action may be assigned to these bever¬ ages, it is unfavorable to digestion, rather than otherwise. Leaving out of consideration the objections which may be urged against the use of tea and coffee on other grounds, the following may be offered as reasons why they are objectionable on account of exerting an injurious influence upon the digestive organs : — 1. Both tea and coffee contain an element resembling tannin, which precipitates or neutralizes the pepsin of the gastric j uice, and so weakens its digestive power. 2. Theine and caffeine, the active principles of tea and coffee, are toxic elements which at first increase and then diminish vital action, thus occasioning debility of the digestive organs from long-continued use. 3. Both tea and coffee are objectionable on the same ground as other beverages in connection with meals, on account of disturbing the di¬ gestion by dilution and consequent weakening of the gastric juice, and overtaxing the absorbents, delaying the digestion of the food and thus giving rise to fermentation. When taken hot, as is the usual custom, these beverages, as do others, at first stimulate but ultimately relax and debilitate the stomach. The objections mentioned as applying to tea and coffee may be urged with equal force against cocoa and chocolate, the effects of which differ from the effects of tea and coffee chiefly in degree. For the other injurious effects of tea and coffee, see chapter on “Stim¬ ulants and Narcotics.” Alcohol. — We have not space in this connection to dwell at length upon the damaging effects of alcohol upon the human system, nor in fall detail of its effects upon the stomach. The following facts, however, are well worth the consideration of those who believe in the use of alcohol either moderately or with greater freedom : — 1. Alcohol itself is an active poison, which when received into the stomach in a concentrated state is almost as quickly fatal to life as is prussic acid or strychnia. It precipitates the pepsin of the gastric j uice, rendering it inert. 2. It irritates the gastric mucous membrane when taken in any but extremely small quantities, even beer and the weaker liquors having this effect when long continued. 3. The ultimate effect of alcohol is to cause degeneration of the se¬ creting glands of the stomach, by which its utility as a digestive organ is destroyed. TOBACCO. 291 Dr. Beaumont’s observations on the effects of alcohol are very posi¬ tive and distinct in their indications. St. Martin being an intemperate man, occasionally indulging freely in drink, Dr. Beaumont had an op¬ portunity of observing the effects of its use, as he was able to look di¬ rectly into his stomach by the aid of a strong light, through the window provided by the remarkable accident from which he had suffered. After he had been drinking freely for several days, Dr. Beaumont found the mucous membrane exhibiting inflamed and ulcerous patches, and the se¬ cretions very greatly vitiated, the gastric juice being diminished in quantity, viscid and unhealthy, although St. Martin did not complain of any unusual feelings, his appetite being apparently unimpaired. The condition became still more aggravated for two days, when the Doctor found that “ the inner membrane of the stomach was exceedingly mor¬ bid, the ery thematic appearance more extensive, and the spots still more livid. From the surface of some of them exuded small drops of grumous blood ; the aphthous patches were large and very numerous, — the mucous covering thicker than common, and the gastric secretions very greatly vitiated. The gastric fluids extracted were mixed with a large proportion of thick, ropy mucus, and a considerable muco-purulent discharge slightly tinged with blood, resembling the discharge from the bowels in some cases of dysentery ” It will be remarked that notwithstanding the very serious condition of his stomach, St. Martin was unconscious of any great disturbance there. This was partly due, no doubt, to the paralyzing effect of alco¬ hol upon the nerves of sensibility. It is owing to this fact that so many suppose that alcoholic drinks have no specially bad influence upon the stomach, when really their stomachs are well-nigh useless from disease but too insensible to indicate their condition. Liquor of any sort taken upon an empty stomach is especially inj urious. Tobacco. — Not infrequently, though less often than is the case with alcoholic liquors, this narcotic drug is recommended as a remedy for dys¬ pepsia. Nevertheless, in the case of tobacco as in that of alcohol, the rem¬ edy suggested is itself an active cause of stomach disease. Only on the similia similibus plan could either one be reasonably employed. Both smoking and chewing weaken and debilitate the digestive organs, though, both of these practices are thought by those who indulge them to stimu¬ late the process of digestion, which they probably do for the time being but only at the expense of subsequent injury. Snuff- taking, especially, 292 AX ATOMY, PHYSIOLOGY, AND HYGIENE. produces gastric irritability, probably by reflex sympathy of the mu¬ cous membrane of the stomach with that of the nasal cavity, which is irritated by the direct contact of the acrid drug. The immense waste of saliva occasioned by chewing and smoking may fairly be considered as one of the means by which the system sus¬ tains loss and injury through the use of tobacco. Those who chew or smoke to prevent excess of fat, should understand that any drug which will exert such an influence upon the system must be a powerfully de¬ structive agent. Those who succeed in keeping down fat by the use of tobacco may depend upon it that they are doing so only at the ruinous expense of their digestive organs, and may look forward with certainty to the breaking down of their nervous systems. Hard Water. — So little attention has been paid to this really common cause of indigestion by writers on this subject, that we can¬ not forbear mentioning it here. Experience has often proved that the use of hard water impairs the integrity of the stomach sooner or later when long continued; and in numerous instances its effects are almost immediate upon persons who visit a hard-water district, having been accustomed to the use of soft water. These injuri¬ ous effects are undoubtedly attributable to the lime and magnesia which are contained in water called hard. These alkalies, as already seen in considering the physiology of digestion, neutralize the gastric juice, and thus work their mischief. There is little necessity for the use of hard water in any part of the country. Where there are not soft-water wells or springs, rain-water may be caught and preserved in cisterns, and by filtration through carbon filters it can be made pure and palatable for drinking and cooking purposes. There is no foundation for the theory that hard water is in any respect more excellent for use than pure soft water. Alkalies. — Soda, saleratus, and the numerous compounds of these substances with ammonia, alum, cream of tartar, etc., are all objectionable on the same grounds as hard water. Being alkaline, they antagonize the action of the acid gastric juice, and thus weaken digestion. There is no more active dyspepsia-producing agent than soda and saleratus biscuit, one of the most common articles of food to be found on the tea-table of rich and . poor in this country. Doubtless, well-prepared baking-powders are much pref¬ erable to soda and cream of tartar or saleratus and sour milk, mixed by the cook in accordance with the not remarkably accurate “ rule PERVERTED APPETITES. 293 of thumb,” through which bungling chemistry the biscuit often pre¬ sent a golden hue which may be attractive to the eye, but gives to the tongue quite too distinct a flavor of soda and potash to be agreeable to a fastidious taste, to say nothing of the probable effect upon a stomach not impregnable against the attacks of chemical agents. In baking-powders, the various ingredients are so mixed as to leave nearly neutral products, and yet these compounds are scarcely less pernicious in their influence upon digestion than the original chemicals from which they are formed. We deem the wide¬ spread and growing use of these chemical bread-making agents bad omens for the digestion of the next generation ; though we read¬ ily grant that if the alternative is between heavy bread and bread made “ light ” with baking-powder, the latter is preferable. Perverted Appetites. — Strangely perverted tastes, as shown in a fondness for earthy and other inorganic or innutritious substances, while sometimes the result of dyspepsia, are often the cause of stom¬ ach disorders, being the result of nervous or mental disease, or being adopted as a habit through example. In South America there are whole tribes of human beings who habitually eat considerable quanti¬ ties of a peculiar kind of clay. Several North American tribes have the same habit, being known as clay-eaters. A similar propensity sometimes appears among more civilized human beings, being almost exclusively confined, however, to young women, chiefly school-girls, who acquire the habit of chewing up slate pencils, and gradually be¬ come so fond of such earthy substances that they have in some in¬ stances been known to eat very considerable quantities of chalk, clay, and similar substances. While indicating a depraved state of the system, and often of the mind also, this practice has a very pernicious effect upon the stomach, which is not intended, as is that of the fowl, to receive inorganic matter of that sort. The amount of abuse of this sort which the stomach will stand, however, is quite astonishing. Dr. Pavy tells a story of an American sailor who saw a juggler pretending to swallow pocket-knives. With the characteristic recklessness of a sailor, and supposing that the knives were really swallowed, he attempted to do the same thing himself, and succeeded in getting down four. Three of these were passed off in two days, but he never saw the other. Six years after, he swallowed fourteen knives in two days, and was taken to a hos¬ pital, where “ he got safely delivered of his cargo.” He was not so 294 ANATOMY, PHYSIOLOGY, AND HYGIENE. fortunate on a subsequent occasion, when he paid dearly for his folly, lingering in misery for some time until he died, when his stomach was found to contain a number of rusty knife-handles, blades, springs, etc., being greatly contracted and corrugated in consequence of the violence which had been done to it. The habit of swallowing cherry pits, apple and other small seeds, is a very reprehensible one. Such objects not only disturb the stom¬ ach, but sometimes find lodgment in the. appendix at the lower end of the coecum, giving rise to inflammation and death. As a general rule, the innutritious parts of foods, as the skins of fruits and vegeta¬ bles, the seeds and cores of apples, and similar parts, should be care¬ fully separated from the nutrient portions and discarded. Adulterations of Food. — The numerous adulterations of food which are now so extensively practiced must be recognized as a not unimportant cause of functional disease of the stomach. Alum in bread and in baking-powders ; lead in drinking-water which has passed through lead water-pipes, or has been stored in lead cisterns, or collected from a roof covered with sheet-tin containing lead ; lead occurring in the tin cans used for preserving fruit, or in tin pans or other tinned ware, or in the glazing of kettles ; vinegar containing sulphuric and other strong mineral acids; pickles boiled in copper or brass vessels and thus poisoned with copper ; sugar adulterated with glucose — or sugar made from corn, refuse starch, etc. — and containing iron, sulphuric acid, tin, etc. ; flavoring extracts made by purely chem¬ ical processes, and containing not a drop of the extract of the fruit after which they are named ; chalk and water in milk, — these, with numerous other equally harmful adulterations, work havoc with the stomachs of people who are so unfortunate as to be victimized. Unseasonable Diet. — The failure to recognize the necessity of adapting the diet to the season and climate is a prolific source of a certain class of dyspeptic disorders. This is especially noticeable when the use of large quantities of carbonaceous food, especially fats and sugar, which may be used in the winter with comparative im¬ punity, is continued into the warm season of the year, or when a diet of this sort is continued in a warm climate by persons who have been accustomed to it in a cold country. It is this sort of transgression of the laws of digestion that gives rise to “ biliousness,” “ bilious dys¬ pepsia,” etc., in many persons. Large quantities of fat and sugar are not well tolerated by the stomach at any time ; and in warm climates, NEGLECT OF THE BOWELS. 295 and the warm season of cold and temperate latitudes, they are ex¬ ceedingly injurious. Pressure upon the Stomach. — The stomach is remarkably sen¬ sitive to pressure. It even sometimes becomes temporarily paralyzed by excess in eating, or by the accumulation of gas from fermentation, by the distension of its walls. It is equally liable to injury of a sim¬ ilar sort from external causes. A sudden blow upon the stomach has been known to produce almost instant death. In ladies, the wearing of corsets, and tight-lacing with or without the corset, are common causes of dyspepsia as well as of other serious diseases. Wearing of the pantaloons drawn tightly, and without suspenders, has a similar effect in men. The soldiers of the Russian army once suffered so much from this cause that it became necessary to correct the evil by a royal edict for the purpose. Very soon after the evil practice was discon¬ tinued, the effects disappeared. Book-keepers and school children from sitting at a desk, seamstresses and tailors from stooping over at their work, shoe-makers, weavers, and washer-women, from direct pressure upon the stomach incidental to their work, suffer from dis¬ turbance of that organ. Drugs. — The continued use of drugs of several sorts, and espe¬ cially of patent medicines, “ bitters,” and “ purgatives,” particularly the latter, has a very damaging effect upon the stomach and bowels. Too much cannot be said lo discourage the use of laxatives, purgatives, “ liver pills,” etc. While sometimes beneficial, agents of this sort, if used for any length of time, are quite certain to work mischief. Pur¬ gatives should never be used except as temporary palliatives. If the bowels require artificial aid, the enema is far preferable ; and yet this plan also has its inconveniences, and results badly if too long contin¬ ued. In general, the less drugs one takes the better. Patent nos¬ trums should be shunned as the most virulent poisons, which in many instances they are. Neglect of the Bowels. — Neglecting to heed the calls of nature promptly and regularly is an abuse of the digestive organs which should not be overlooked. The bowels are as much a part of the ali¬ mentary canal as is the stomach ; and they have an important part to act in absorbing the digested food. They are also important excreting organs, some of the worst poisons generated in the system passing off through them. The feces are made up, not chiefly of the remains of food, as many persons suppose, but of impurities thrown out of the 296 ANATOMY, PHYSIOLOGY, AND HYGIENE. system by the intestinal mucous membrane. When these excrementi- tious substances, the foulest in the body, are retained, they are to some extent reabsorbed, thus poisoning the system. Every physician is familiar with the peculiar fecal odor of the breath of a costive child, an evidence of the absorption referred to. The bowels naturally move once a day with most people, and com¬ monly soon after breakfast. A few persons habitually move their bowels only every other day, without injury, while some persons find it necessary to relieve the bowels twice in twenty -four hours. How¬ ever the habit may be, it should be regular. Every person should have a definite time for attending to the relief of the bowels as system¬ atically and punctually as in taking meals. This is a matter of very great importance ; piles, or hemorrhoids, fissure and fistula, prolapsus of rectum and also of the womb, and a host of other evils, begin in constipation of the bowels. To encourage the needed regularity and promptness in attending to the bowels, it is important that comfortable accommodations for the purpose should be provided. The custom of building a small, loose shed at a considerable distance from the house is a bad one, as it sub¬ jects women and children, especially, to unpleasant and even danger¬ ous exposure during the cold months of the year. Still more to be deprecated is the custom, quite prevalent in the West, of dispensing with privy accommodations altogether. The closet should be near the house, and should be made warm and convenient, and properly screened. If judiciously taken care of, it need not be a nuisance or a cause of disease, even if adjoining the house or within it. The earth- closet plan is an excellent arrangement for winter. A very eminent medical gentleman, a man of long experience as a specialist in the treatment of diseases of women, affirms his belief that not a. few of the serious maladies from which women suffer are due to neglect of the bowels. The best remedies for constipation are given under the proper head. Mental Influence. — The digestive process is very greatly under control of the mind. The connection between the mind and the stomach is so intimate that Yan Helmont maintained for a lon£ time that the stomach was the seat of the soul. By any strong emotion the whole digestive apparatus may suddenly cease to act. Fear, rage, and grief check the salivary secretion, and without doubt the gastric HYGIENE OF THE TEETH. 997 * also. Through the mind, the appetite may be either encouraged or quite destroyed. A man who sits down to his dinner with his mind depressed with business cares, the embarrassment of debts, or the anxiety of doubtful speculations, cannot hope to digest the most carefully selected meal. The woman who dines with her mind disturbed with discontent, fret¬ fulness, and worriment, is certain to suffer with indigestion. Domestic infelicity may well be counted as at least an occasional cause of di¬ gestive derangements. Meals eaten in moody silence are much more apt to disagree with the stomach than those which are accompanied by cheerful conversation. A hearty laugh is the very best sort of condiment. Cheerfulness during and after meals cannot be too highly rated as an antidote for indigestion. Hygiene of the Teeth. — Defective teeth, by interfering with the complete and thorough mastication of food, seriously impair the di¬ gestion. On the other hand, impairment of digestion, and perversion of the secretions, is a very common cause of decay of the teeth. Thor¬ ough mastication is essential to good digestion ; and no one can hope to preserve a good digestion while munching food with toothless gums, or subsisting on a dietary that requires no use of teeth. So rapid is the increase of degeneration of the teeth in modern times, that we have asked ourselves more than once the question, Mill the American race become toothless ? Not quite, perhaps; at least not so long as artificial dentures can be manufactured from such a variety of substances and made to answer so useful a purpose as masticators. Indeed, some people already afford two sets of teeth — a set for every day, for rough usage, and an extra-fine set for exhibition on special occasions. But at the present rate of deterioration, not many more generations will appear before we shall find a toothless race, ship¬ wrecked in health, with digestion bankrupt, and “nerves” the dom¬ inant feature. Barely indeed, do we find a person at thirty years of age with a set of sound teeth. Far moro often do we find young lads and girls of ten to sixteen years of age whoso teeth are mere shells of decaying tissue, rotting away with almost visible rapidity, depositories of de¬ caying particles of food, and millions of wriggling animalcules, and the sources of contaminating elements which deteriorate digestion, and of offensive odors which contaminate the breath. In confirmation of these statements respecting the condition of American masticators 208 ANATOMY, PHYSIOLOGY, AND HYGIENE. it may be mentioned that there are 12,000 dentists in the United States, who annually extract twenty million teeth, manufacture and insert three million artificial teeth, and hide away in the cavities of carious teeth three tons of pure gold, to say nothing about the tons of mercury, tin, and other metals employed in “ fillings.” For the preservation of the teeth we offer the following rules, which, if thoroughly carried out, will certainly secure good results un¬ less the teeth are ruined by incurable constitutional disease : — 1. See that the teeth are properly developed. To this end, supply the child while an infant, and even after, with an abundance of food which is rich in “salts,” such as peas, beans, graham bread, oatmeal, and the like, and carefully watch the first set of teeth as they are developed and give place to the permanent set. 2. Have a tooth filled as soon as the smallest appearance of decay is discovered; and in order to discover the very beginnings of decay, ex¬ amine them frequently, or have a dentist do so. If a child complains of toothache, take him to a good dentist at once, for something is cer¬ tainly wrong. It is a mistake to suppose that it is not worth while to have first teeth filled, since others will come in their place. Unless the tooth is about to be displaced by the permanent tooth, it should be filled, for the benefit of the coming permanent tooth as well as for the present health and comfort of the child. 3. Cleanse the teeth night and morning, as well as after each meal, taking care to remove all particles of food, brushing and rinsing well. Use soap and powder at least once a day. Give attention to the back teeth, and the inside as well as the front teeth, which are apt to re¬ ceive chief attention for the sake of appearance, when they need the least. 4. Never allow mineral acids of any kind, nor such preparations as chloride or sulphate of iron, to touch the teeth, as they will destroy the enamel. 5. Avoid allowing gritty substances to come in contact with the enamel, as they will scratch and mar it, and perhaps cause the beginning of decay. 6. If possible, never lose a tooth. An eminent physician once said that we lose a year of life every time we part with a tooth. They are too valuable to lose when by a trifling expense they may be saved. 7. Never employ traveling dentists nor purchase or use patent com¬ pounds for the teeth. Many of them contain substances which will de¬ stroy the enamel or induce disease of the gums. CARE OF TEE TEETH. 299 8. Never carry “old stumps ” in the mouth. If they cannot be filled, have them extracted. Nothing is much more repulsive than a mouth full of stumps of rotten teeth. We would much rather encouuter the decomposing carcass of a dead dog than a person with such a mouth ; for we could easily run away from the former, but might be compelled to tolerate the presence of the latter notwithstanding the nuisance. 9. If the teeth are utterly in ruins and can in no way be repaired so as to make them really serviceable, they should be replaced by good artificial teeth. It should be borne in mind, however, that the natural teeth are much superior to any artificial substitute ; and hence they should not be sacrificed without making all possible efforts to save them. Many times dentists advise the drawing of teeth for the purpose of securing the opportunity to make a new set ; hence it is important that advice should be sought from a skillful and trustworthy source. 10. Artificial teeth must be cared for with as much scrupulous regularity and thoroughness as natural teeth in order to preserve the health of the mouth. They should be removed from the mouth at night and placed in a glass of water, and in the morning should be thoroughly cleansed with fine soap or with a solution of chlorinated soda, which can be obtained of any druggist. Artificial dentures should also be removed from the mouth and thoroughly cleansed after each meal. 300 ANATOMY, PHYSIOLOGY, AND HYGIENE. SECRETION AND EXCRETION. The nutrition or maintenance of the body in health, involves two essential processes, assimilation and disintegration, or dis-assimila- tion. Assimilation is the process by which the nutritive material fur¬ nished to the tissues in the blood is made into tissue, each tissue possessing the power to renew itself from the elements found in the blood. Dis- assimilation is the process of tissue waste or breaking down. Every act, thought, sensation, no matter how slight, results in the waste or breaking down of tissue. As accessory to these two great processes, we have secretion and excretion. Secretion is the formation from the blood of something which did not exist in it, but which is produced by transformation of some of the elements which it contains, for the pur¬ pose of aiding in some vital process. Assimilation is really a secretory process, each tissue possessing the power to secrete tissue like itself. Excretion is the removing from the blood of the products of tissue waste which are washed out of the tissues by the venous blood. Secretions. — The principal secretions are the following : 1. The digestive fluids, comprising the saliva, gastric juice, bile, 'pancreatic juice, and the intestinal juices, all of which have been described ; 2. Serous fluids, produced by serous membranes for the purpose of lubri¬ cation ; as by the peritoneum, which lines the abdominal cavity and covers the intestines; the pericardium, which incloses the heart; the pleura, which covers the lungs and lines the chest; the membranes of the brain, etc. ; 3. Synovial fluid, which is formed by the synovial mem¬ branes of joints for the purpose of lubrication ; 4. Sebaceous matter, which is formed by minute glands in the skin and some parts of the mucous membrane for the purpose of protecting the skin, and keeping it in a supple condition ; 5. Various other fluids formed by small glands which are imperfectly understood, as the pineal gland and pituitary body of the brain. Excretions. — The principal excretory products are the siveat, mu¬ cus, urine, bile, and carbonic acid, eliminated respectively by the skin, the mucous membrane, the kidneys, the liver, and the lungs. The ex¬ cretions are not produced by the organs named, but by the tissues, the THE SKIN— SWEAT-GLANDS. 301 organs mentioned simply serving to separate the various morbid ele¬ ments from the blood. Without going into the minute details of the subject, we will now consider the structure and functions of the principal secreting and ex¬ creting organs which have not been already described. The Skill. — The general structure of the skin has been described in connection with the consideration of the sense of touch (see page 166), and hence we need consider here only the points there omitted; viz., the secreting and excreting organs of the skin, and the hair and nails. A reference to Plate IV will give quite a clear idea of the relations of the sweat glands, the hair, and the sebaceous glands, to the general frame¬ work of the skin. The area of the skin in an adult is twelve to sixteen square feet. Tli© Sweat Glands. — A close examination of the little ridges found upon the palms of the hands, by the aid of a small magnifying-glass, will reveal what appear to be fine transverse lines crossing the ridges at short intervals. A closer inspection shows that the apparent lines are really extremely minute openings, guarded by delicate valves. These are the mouths of the perspiratory ducts, which convey to the sur¬ face the product of the sweat glands. The gland itself is merely a coiled tube, situated deep down in the true skin, and surrounded with a net-work of blood- vessels. The duct is simply a continuation of the same tube upward through the cuticle to the surface. It passes out upon the surface of the skin obliquely, thus leaving a small portion of the cuticle overlapping its orifice, forming a sort of valve. The number of these delicate glands is enormous. It has been care¬ fully estimated to be about 2,300,000 in a single individual. The length of each is about one-fifteenth of an inch, making their aggregate length about two and one-half miles. Between two and three pounds of sweat is thrown off* each day. The perspiratory secretion consists of water holding in solution various excretory principles, the chief of which is urea, which is also elimi¬ nated by the kidneys, and is one of the most important excretory products. The amount of urea varies somewhat with the amount elim¬ inated by the kidneys. The sweat also contains a large proportion of chloride of sodium. In certain parts of the body, particularly the arm- pits and between the toes, the sweat glands are more numerous than in most other parts, and the perspiration often has a peculiar and offensive 302 ANATOMY , PHYSIOLOGY , .4N.D HYGIENE. odor. The sweat secretion is usually acid ; but when so strongly odor¬ ous it is found to be alkaline. • The Hair. — With the exception of the palms of the hands and the soles of the feet, the whole surface of the body is covered with hairs, which vary much in length and thickness in different parts of the body. The majority are soft and fine, those upon the head and a few other parts of the body being long and silky. The hairs found upon the head average about xro of an inch in diameter, varying from to -3-5V0 of an inch. Dark hair is usually coarser than light. The color of the hair is due to pigment of the same nature as that which gives color to the eye and skin. The number of hairs upon the entire head is about 120,000. Straight hairs are nearly round. That which is curled is elliptical. The hair of the negro is flat. Hair possesses the peculiar property of becoming strongly electric when rubbed. This is especially manifested in cold, dry weather. When combed in the dark, sparks may be seen to issue from it. This may be well seen in rubbing the back of a cat, stroking to¬ ward the head. Most hairs are hollow, beiim reallv hollow tubes, the outside being covered with a layer of overlapping cells. When viewed with a microscope, the hair looks rough and serrated. This peculiarity can be demonstrated by a simple experiment. Place two hairs between the thumb and finger with the roots the same way. Now make a slight side movement with the thumb and finger, thus rubbing the hairs alter¬ nately in different directions. Two smooth wires so treated would re¬ main in the position in which they were placed ; but the hairs will be seen to move with each alternate movement of the fingers, and always toward the root. Now if one hair be changed so that its root is in the same direction as the tip of the other, the same rubbing will cause them to move in opposite directions. The hairs grow from little pouches in the skin. The root of a hair greatly magnified is shown in Fig. 1 30. The hair serves a useful purpose in Pig-. 130. The Root of a Hair, showing nutrient blood-vessels at the base. FUNCTIONS OF TEE SKIN. 303 protecting the body, giving additional warmth in some places, and in hot climates protecting the head from the heat of the sun, being a good non-conductor. It also diminishes the friction of clothing. The mus¬ tache protects the lungs from dust. Connected with each hair follicle is a little band of involuntary muscular fibres, one end of which is attached to the follicle, the other to the skin near by. Under the influence of cold these muscles contract, puckering the skin and producing the peculiar appearance known as goose-flesh. Sudden Blanching of the Hair. — Cases have occurred, in which, under the influence of fear, grief, or some other strong emotion, the hair has turned white in a single night, a week, or some other short period. Examination of hair thus affected has shown that the cause of the change of color is the appearance in the hair of great numbers of minute air-bubbles. The Sebaceous Glands. — Connected with the hair follicles are lit¬ tle glands for the secretion of a fatty substance. These glands discharge their contents into the hair follicles, whence they reach the skin. The Nails. — These are horny plates which grow from a fold of skin near the ends of the fingers and toes. They are formed in a man¬ ner much similar to that in which the hairs are produced. Their object is to protect the ends of the fingers and toes. Functions of the Skin. — The skin performs a number of very important offices for the body. Perhaps the most important is that of excretion. Each of its millions of sweat glands is actively and con¬ stantly engaged in separating from the blood impurities which would destroy life if retained. These foul products are poured out through a corresponding number of minute sewers, and deposited upon the surface of the body to the amount of several ounces each day, or sev¬ eral pounds, if the whole perspiration be included in the estimate, as is commonly done. The skin is also an organ of respiration ; it absorbs oxygen, and exhales carbonic acid gas, with other poisonous gases. The amount of respiratory labor performed by the skin is about one-sixtietli of that done by the lungs. In some of the lower animals, the whole work of respiration is performed by the skin. In the common frog, the respi¬ ratory action of the skin and of the lungs is about equal. Another important office of the cutaneous tissue is absorption. 304 ANATOMY, PHYSIOLOGY, AND HYGIENE. The absorption of oxygen has already been referred to ; but it ab¬ sorbs liquids as well as gases, and to a much greater extent. By im¬ mersion in a warm bath for some time, the weight of the body may be very considerably increased. Dr. Watson, an English physician of note, reports the case of a boy whose weight increased nine pounds in twenty-four hours, solely by cutaneous absorption of moisture from the air. This extraordinary action was occasioned by disease. Seamen, when deprived of fresh water, quench their thirst by wetting their clothing with sea-water, the aqueous portion of which is absorbed by the skin. The lymphatic vessels are believed to be the principal agents in absorption. Another remarkable function of the skin is the regulation of tem¬ perature. By its density and non-conducting property it prevents the escape of necessary heat to a considerable degree. But when the amount of heat generated in the body becomes excessive, either from abnormal vital activities, or by exposure to external heat, the skin re¬ lieves the suffering tissues by favoring the escape of heat. This de¬ sirable end is attained through the evaporation of the moisture poured out upon the surface by the perspiratory glands. It has been estimated that the evaporation of water from the cu¬ taneous surface and from the mucous membrane of the lungs occasions the loss each minute of sufficient heat to raise a pint of water 100° F. in temperature. This is certainly a powerful cooling process. Lastly, we mention as a further function of the skin, and one which is not the least in importance, its utility as a sensitive surface. It is a well-established physiological fact that the mind is only a re¬ flection of impressions received from without, or at least that its char¬ acter is largely determined by the nature of the impressions made upon its organs of sensibility. The skin is the organ of touch, and of the various modifications of tactile sensibility. It is the most exten¬ sive organ of sensibility in the body, and is very closely connected with all the great nerve centers, so that it is perhaps the most effi¬ cient means through which to affect the general nervous system. Its intimate sympathy with internal organs is shown in the great number of diseases in which this organ evidently sutlers on account of disabil¬ ity of some internal part. The importance of the functions of the skin is shown by the fact that a person quickly dies when its action is interrupted. A coat of varnish or caoutchouc, applied over the whole skin, will kill a man al- CLEANLINESS. 305 most as quick as a fatal dose of strychnia. In illustrative experi¬ ments, horses, dogs, and other animals have been killed by obstructing the action of the skin by some similar means. A little boy was once killed by covering him with gold-leaf to make him represent an angel at a great celebration. The offensive odor of the perspiration, and the characteristic smell of the sweat-soiled under-clothing of a tobacco-user, are facts which well attest the value of the cutaneous functions in removing impuri¬ ties from the body. Cleanliness.— The skin is one of the most important depurating organs of the whole body. From each of its millions of pores con¬ stantly flows a stream laden with the poisonous products of disinte¬ gration. As the water evaporates, it leaves behind these non-volatile poisons, which are deposited as a thin film over the whole surface of the skin. As each day passes, the process continues, and the film thickens. If the skin is moderately active, three or four days suffice to form a layer which may be compared to a thin coating of varnish or sizing. The accumulation continues to increase, unless removed, and soon undergoes further processes of decomposition. It putrefies, rots, in fact, and develops an odor characteristic and quite too famil¬ iar, though anything but pleasant, being at once foul, fetid, putrid, pungent, uncleanly, and unpardonable. But the offense to the nose is not the extent of the evil. The un¬ clean accumulation chokes the mouths of the million little sewers which should be engaged in eliminating these poisons, and thus ob¬ structs their work. Being retained in contact with the skin, some portions are reabsorbed, together with the results of advancing decay, thus repoisoning the system, and necessitating their elimination a sec¬ ond time. Here water serves a most useful end if properly applied. It is un¬ excelled as a detergent, and by frequent application to the skin will keep it wholly free from the foul matters described. The necessity for frequent ablutions is well shown by the fact that nearly two pounds of a poison-laden solution, the perspiration, is daily spread upon the surface of the body. It is not an uncommon occurrence to meet with people who have never taken a general bath in their lives. Imagine, if possible, the condition of a man’s skin, at the age of sev¬ enty or eighty years, which has never once felt the cleansing effects of a thorough bath I 20 306 ANATOMY, PHYSIOLOGY AND HYGIENE . One of the most serious effects of this accumulation of filth is the clogging of the perspiratory ducts. Their valve-like orifices become obstructed very easily, and depuration is then impossible. It is not wonderful that so many people have torpid skins. The remedy is ob¬ vious, and always available. How to 3Iake the Skin Healthy. — A man who has a perfectly healthy skin is nearly certain to be healthy in other respects. In no way can the health of the skin be preserved but by frequent bathing. A daily or tri-weekly bath, accompanied by friction, will keep the skin clean, supple, and vigorous. There is no reason why the whole surface of the body should not be washed as well as the face and hands. The addition of a little soap is necessary to remove the oily secretion deposited upon the skin. A lady of fashion, in enumerating the means for preserving beauty, says : “ Cleanliness, my last recipe (and which is applicable to all ages), is of most powerful efficacy. It maintains the limbs in their pliancy, the skin in its softness, the complexion in its lustre, the eyes in their brightness, the teeth in their purity, and the constitution in its fairest vigor. To promote cleanliness, I can recommend nothing preferable to bathing. The frequent use of tepid baths is not more grateful to the sense than it is salutary to the health and to beauty . By such means, the women of the East render their skins softer than that of the tenderest babe in this climate.” “ I strongly recommend to ev¬ ery lady to make a bath as indispensable an article in her house as a looking-glass.” When the foul matters which ought to be eliminated by the skin and quickly removed from the body are allowed to remain undisturbed, the skin becomes clogged and inactive, soon loses its natural lustre and color, becoming dead, dark, and unattractive. When bathing is so much neglected, it is no marvel that paints, powders, lotions, and cosmetics of all sorts, are in such great demand. A daily bath, at the proper temperature, is the most agreeable and efficient of all cosmetics. Bathing Protects against Colds.— It is an erroneous notion that bathing renders a person more liable to “ take cold, by opening the pores.” Colds are produced by disturbance of the circulation, not by opening or closure of the pores of the skin. Frequent bathing in¬ creases the activity of the circulation in the skin, so that a person is far less subject to chilliness and to taking cold. An individual who takes a daily cool bath has perfect immunity from colds, and is lit- Demodex Folliculonwi. A earns Scabei (Itch Mite.) Demodex Folliculnnun. Plate VI] I ARISTOCRATIC VERMIN. 307 tie susceptible to changes of temperature. Colds are sometimes taken after bathing, but this results from some neglect of the proper precau¬ tions necessary to prevent such an occurrence, which are carefully stated elsewhere in this work. Aristocratic Vermin. — Doubtless, not a few of those very refined and fastidious people who spend many hours in the application of all sorts of lotions and other compounds to the face and hands, for the pur¬ pose of beautifying those portions of the skin exposed to view — while neglecting as persistently those parts of the skin protected from observa¬ tion — would be very much surprised to learn the true condition of the unwashed portions of their cutaneous covering. They instinctively shrink with disgust from the sight of a vermin-covered beggar, in whose cuticle burrows the acarus scabiei (itch-mite), while troops of larger in¬ sects are racing through his tangled locks and nibbling at his scaly scalp. It is quite possible that many a fair “unwashed” would faint with fright if apprized of the fact that her own precious covering is the home of whole herds of horrid-looking parasites which so nearly resemble the itch-mite as to be at least a very near relative, perhaps half-brother or cousin. The name of this inhabitant of skins unwashed is as formida¬ ble as the aspect of the creature, though it does not require a microscope to display its proportions, as does the latter; scientists call it, demodex folliculorum. See Plate VIII. The demodex makes himself at home in the sebaceous follicles, where he dwells with his family. Here the female lays her eggs and rears her numerous family, undisturbed by the frictions of any flesh-brush, and only suffering a transient deluge at very long intervals, if such a casualty happens. In studying the structure of these little parasites, we have found several tenants occupying a single follicle, pursuing their do¬ mestic operations quite unmolested by any external disturbance. The demodex has been transplanted from the human subject to the dog; and it is found that the new colony thrives very remarkably, and soon produces a disease apparently identical with that known as “ mange.” We have not space to describe in detail these savage little brutes, with their eight legs, armed with sharp claws, bristling heads, sharp lancets for puncturing and burrowing into the skin, and their powerful suckers for drawing the blood of their victims. We care only to impress upon the mind of the reader the fact that neglect of bathing and friction of the skin is sure to encourage the presence of millions of these para¬ sites, and that the only remedy is scrupulous cleanliness of the whole 308 ANATOMY, PHYSIOLOGY, AND HYGIENE. person. Like their relatives, the itch-mite, they do not thrive under hy¬ dropathic treatment, and are very averse to soap and water. The best way to get rid of them is to drown them out. They do not produce the irritation which characterizes the presence of the itch insect, so that this evidence of their presence is wanting. But they are sure to be present in a torpid, unhealthy, unwashed skin, no matter how delicate or fastid¬ ious its possessor. Bathing a Natural Instinct. — All nature attests the importance of the bath. The rain is a natural shower bath in which all vegetation participates, and gains refreshment. Its invigorating influence is seen in the brighter appearance, more erect bearing, and fresher colors of all plants after a gentle rain. The flowers manifest their gratitude by ex¬ haling in greater abundance their fragrant odors. Dumb animals do not neglect their morning bath. Who has not seen the robin skimming along the surface of the lake or stream, dipping its wings in the cool waters, and laving its plumage with the crystal drops that its flapping pinions send glittering into the air ? No school-boy who has ever seen the elephant drink will forget how the huge beast improved the oppor¬ tunity to treat himself to a shower bath, and perhaps the spectators as well, for he is very generous in his use of water. If man’s instincts were not rendered obtuse by the perverted habits of civilization, he would value the bath as highly and employ it as freely as his more humble fellow-creatures, whose instinctive impulses have re¬ mained more true to nature, because they have not possessed that degree of intelligence which would make it possible for them to become so grossly perverted as have the members of the human race. Man goes astray from nature not because he is deficient in instinct, but because he stifles the promptings of his better nature for the purpose of gratifying his propensities. Clothing . — The natural requirements for dress are the following: — 1. Modesty requires that the body should be clothed. 2. Protection against sudden changes of temperature is required for the maintenance of health. The dusky savage who roams the tropical wilds of Central Africa finds no necessity for clothing. Modesty is to him unknown. The gen¬ ial climate of his native forests insures him against vicissitudes of tem¬ perature, and so he lives as he was born, protected only by the swarthy cloak which nature gave him. Civilization creates the first requirement for clothing, and the varying temperatures of the temperate and frigid zones create the second. ESSENTIAL QUALIFICATIONS OF CLOTHING. 309 Essential (Qualifications of Clothing.— In. order to properly meet the wants of the body in fulfilling the above requirements, clothing- must possess the following qualifications: — 1. It must allow unrestrained action of every organ of the body. 2. It must secure equable temperature of all portions of the body. 3. Its weight must be as light as possible without sacrificing other necessary qualities. 4. It must be so adjusted to the body as to be carried with the slight¬ est possible effort. It will be admitted at once that clothing such as will meet the above requirements is not what is recommended by the fashion leaders of the day ; but if ladies would forget fashion and make their garments in ac¬ cordance with the principles of sound common sense, they would soon be delighted to find themselves emancipated from the numerous ills which afflict them in consequence of their present mode of dress, as has been al¬ ready pointed out. It may be that circumstances will not always allow of the adoption of a dress which shall be wholly physiological in every respect, which is to be regretted. Custom has so long ruled that we are forced to yield a little to its mandates, though reluctantly. But it is quite possible for every woman to adopt a dress which shall be, in all essential particulars, free from serious defects, and that without sacrific¬ ing an iota of her native grace or modesty, or making a martyr of her¬ self or her friends. In the first place, the corset and all its substitutes and subterfuges, tight belts, and every other device for compressing the waist or any other part of the body can be at once discarded without the attention of any one being drawn to the fact unless it be by the more elastic and graceful step, the brighter color of the face, and the general improvement in health in all respects. Suppose the waist does expand a little — or a good deal, even — beyond the standard seventeen inches; is it any disgrace ? No, indeed. A woman ought to be proud of a large waist. A large waist indicates large lungs, and large vital organs, which, in turn, rep¬ resent the probabilities of long life. A small waist indicates precisely the opposite. Why should woman — the gentler sex — be compelled to wear a strait-jacket, like a madman or a criminal, while man is allowed to go untrammeled by any such impediment ? A strong popular senti¬ ment in favor of large waists would soon do away with the foolish emu¬ lation to look frail and slender. If required, a suitable garment may be made, to support the bust, which will fit the form neatly without com- 310 ANATOMY, PHYSIOLOGY , AND HYGIENE pressing any part. Able physicians declare that compression of this part of the body, and the wearing of an undue amount of clothing, thus pro¬ ducing a local increase of temperature, is the cause of many of the pecul¬ iar diseases of woman, acting through reflex influence upon internal or¬ gans. The next important step should be to regulate the clothing prop¬ erly. The whole body should be clad in soft flannel from neck to wrists and ankles nearly the year round. It is better to have the un¬ derclothing for the upper part of the body and that for the limbs combined in one garment. If arranged in two garments, they should only meet, and not overlap, as this gives too much additional heat over the abdominal organs. A woman’s limbs require as many thick¬ nesses as a man’s ; and a garment which fits the limb closely will afford four times the protection given by a loose skirt. Thick shoes or boots with high tops, and heavy woolen stockings which are drawn up outside the undergarments clothing the limbs, complete the pro¬ vision for warmth. Leggins should be worn in cold weather. All the undergarments should be suspended from the shoulders by means of waists or suspenders. Waists are doubtless the better for the purpose. If several garments are to be suspended from the same waist, the rows of buttons to v. liich they are attached should be ar¬ ranged one above another, to avoid bringing several bindings together. The two most important particulars having been secured — freedom from compression and uniform temperature — the outside dress may receive attention. It should be as simple as possible, and consistent with the mental comfort of the wearer. Gaudy colors and conspicu¬ ous ornaments betray poor taste and a vain, shallow mind. Many flounces, folds, and heavy overskirts are objectionable on account of their weight, to say nothing of the useless expenditure of time and money which they occasion. The proper length of the skirt is a question of interest in this con¬ nection. How long shall it be ? If physiology alone were asked the question, the answer would be that women do not need long skirts more than men, and that they are really an impediment to locomo¬ tion, and often very inconvenient. Long-established custom says that women must wear skirts. Fashion says she must wear long skirts. Custom and fashion have prevailed so long that they have created an artificial modesty which seems to demand that woman’s dress shall differ from man’s by the addition of a skirt, at least, even if they are FALSE HAIR AND HAIR DYES. 311 alike in all other particulars. This being the case, the best we can do is to modify the skirt so that it will be as free from objections as pos¬ sible. The great evils of long skirts are, unnecessary weight, the ac¬ cumulation of moisture which is transferred to the feet and ankles, and sundry inconveniences to the wearer in passing over rough places, up and down stairs, etc. The obvious remedy for these defects is to curtail the length of the dress. The train must be discarded at once as too absurd and un¬ cleanly, with its filthy load of gleanings from the gutter, to be toler¬ ated. Any further improvement, to be of practical utility, must shorten the skirt to the top of the ankle ; and a radical dress-reformer will want to make it a few inches shorter. A very serious mistake is made by those who adopt the reform in the length of the dress, even to the fullest extent, but make no reform in other respects. Such overlook the chief defects which need refor¬ mation, paying their whole attention to a point which, considered from a physiological standpoint, is of minor importance, although well deserving of all the attention it receives. False Hair and Hair Dyes. — The ungainly masses of unneces¬ sary material which fashion has heaped upon the heads of those who bow to her authority, are a frightful cause of diseases of the scalp and brain. The immense loads of hair, jute, or other material, which are attached to the head, cause a great increase of the temperature of the brain and scalp. The blood-vessels become congested, both externally and internally. The result of this constant surplus of blood is disease of the scalp and of the brain itself. Headache is an almost constant symptom of the injury which is being wrought by this improper treat¬ ment of the head. In consequence of the disease of the scalp, the hair soon becomes diseased, loses its brilliancy and color, becomes dry and harsh, and in many cases is lost altogether, complete and incurable baldness ensuing. The congestion of the brain which at first occasions only headache, when continued produces structural disease of that organ. The blood¬ vessels become weakened, and sometimes ruptured, when the patient either dies of apoplexy or lingers a miserable paralytic. When the head is encumbered with an unnatural mass of hair, and the brain is clogged by the excessive amount of blood and supei’natural heat which result, the mind cannot act freely and naturally ; hard study, deep thought, and continued mental exercise are impossible. This is the 312 ANATOMY, PHYSIOLOGY , AND HYGIENE. reason why fashionable young ladies find study so hard for them, and apparently injurious. The incubus of such a prodigious weight as many a fashionable lady carries upon her cranium would be quite suffi¬ cient to eclipse the mental powers of the most brilliant genius. No wonder that woman has sometimes failed in mental competition with her brothers in the schools. The wonder is that she lives and possesses even a modicum of mental vigor. Under equally favorable circumstances, woman should be man’s peer in mental power and development ; but if she wishes to secure and maintain the equality of the sexes, which so many earnest women are just now demanding, she must throw away her chignons and waterfalls, shake off her “ rats and mice,” and don a simpler, healthier head-gear. The real hair that is sold to those whose tresses are considered too scanty is chiefly obtained from the bodies of dead persons, whose graves are plundered for the purpose by wretches who earn their living by this means. Vermin of various kinds often adhere to the hair, and infest the heads of those who wear it. Various imitations of hair also become the means of conveying loathsome parasites to the scalps of those who wear them. The use of hair dyes is a practice which the chemist and experience have both shown to be eminently dangerous. All hair dyes are poison¬ ous. No matter how strong the assertions of their harmlessness, they are utterly false. So-called vegetable hair dyes, hair invigorators, ton¬ ics, etc., are contemptible swindles. They contain mineral poisons. The greater portion of them contain lead. The effect of their use is not only to destroy the hair, and induce disease of the scalp, but to produce paralysis. Many cases of chronic headache have been occasioned by the use of these poisonous mixtures ; and in a number of cases, insanity has been the result. The use of these vile compounds, which are so widely sold and used, is usually as absurdly foolish as harmful. The Kidneys. — Figs. 131 and 132. These organs are located in the back part of the abdominal cavity, between the lower ribs and the upper border of the hip bone. In shape they resemble a kidney-bean, and each weighs four to six ounces. The greater portion of the kid¬ ney is made up of minute tubes, which terminate in the outer part of the organ in extremely minute round sacs, each of which contains a delicate, coiled capillary blood-vessel. It is by these bodies that the elements of the urine are separated from the blood. Ail the tubes TIIE LIVER AND BILE. 313 Fig:. 131. The Kidney, showing the arteries and veins of the organ ; 13. the Supra-renal Capsule ; and 3. the Ureter. lead toward the center of the organ, where they empty into a cavity called the pelvis of the kidney, which narrows down into a small ca¬ nal, the ureter, by which the urine is conveyed to the bladder, a pouch-like reservoir located in the lower part of the abdomen, from which the urine is discharged through another small canal, the urethra. The urine is chiefly composed of water, which carries in solution a large number of excrementitious principles, the chief of which is urea, one of the most abundant and most poisonous of all the waste elements of the body. When the liver is inactive, the urine usually contains some biliary elements. Sugar is also found in the urine soon after a meal in which an excess has been taken. The condition of the urine is an important means of ascertaining the state of the system, and hence we shall speak elsewhere of the various points to be learned by its chemical and microscopical examination. The Liver. — This is the largest gland in the body, weighing between four and five pounds. It is a little larger, proportionately, in women than in men. The liver is made up of minute, roundish lobules, about -fa of an inch in diameter, each of which is fur¬ nished with branches from the hepatic artery and also from the portal vein. The liver thus contains a double capillary net-work. In addition, there is a system of minute ducts or canals running through its whole sub¬ stance, by means of which the bile which is separated from the portal vein is drained off into a pouch upon its under surface, the gall bladder, or into the small intestine. The Bile. — This is a greenish, bitter, alkaline fluid, somewhat viscid in character. The amount produced each day is about two and one-half pounds. It is produced much more rapidly during di¬ gestion than at other times. Figr. 132. Showing the in¬ ternal structure of the Kidneys. 314 ANATOMY, PHYSIOLOGY, AND HYGIENE. As already observed, the bile is both a secretion and an excretion. As a secretion, it aids digestion. As an excretion, it removes from the body a poisonous substance called cholesterine, a waste product of ITig:. 133. Spleen. the nervous system. This, when concentrated, is found to be a resin¬ ous substance. It forms the chief part of many gall-stones. The functions of the liver are somewhat com¬ plicated. In addition to its secreting and excretory functions, it is thought to be a sugar-forming organ, and to be capable of completing the digestion of some elements of the food. It is thought by some, also, that it destroys and removes from the system worn-out red blood corpuscles. The Spleen. — Among other glands should also be mentioned the spleen (Fig. 133), a gland found in the left side of the abdominal cavity next to the left end of the stomach, to which it is attached. Its weight is about seven ounces. It belongs to a class of structures known as blood glands or ductless glands, because it has no duct. However, it re¬ ceives a very large supply of blood, and is supposed to have some¬ thing to do with the production or destruction of blood corpuscles. It may be removed from the body, in animals, without producing death. The effect of its removal in cats is to cause them to become very fat. It is also observed that they become very irritable after its removal. It is said that the farmers in some parts of England make a practice of removing the spleen in young calves in order to cause them to fatten faster. Other Blood Glands. — Under this head are also included the supra-renal capsules, which are attached to the upper part of the liver; the thyroid gland, situated at the upper part and on either side of the trachea; the thymus gland, found only in early life, at the lower part of the trachea; the pituitary body and the pineal gland, found in the central part of the brain. Of these glands little else is known than their location and structure. Animal Heat. — Warm-blooded animals possess the power to reg¬ ulate their own temperature independent of external temperatures, at least within certain limits. What are called cold-blooded animals do not possess this power, their temperature depending on that of the medium with which they are surrounded. The source of animal heat is the various vital changes constantly taking place in the body. ANIMAL HEAT. 315 This is shown by the fact that the amount of heat produced is exactly proportionate to the intensity of the vital changes. In health the temperature of the body is about 98|° F. When the system is under the influence of fever or an extensive inflammation of any sort, — which process greatly accelerates vital changes, — the temperature rises several degrees above the normal standard, sometimes as high as 110* F., though a temperature above 107° is considered to be almost cer¬ tainly fatal if long continued. This same principle is observed in lower animals and even in flowering plants. The latter absorb oxygen most rapidly when flowering; and in many instances it has been shown by careful experiment that the process of flowering in plants is accompanied with a marked production of heat. Birds absorb large quantities of oxygen, and have very active vital processes. In them the temperature of the body is several degrees higher than in man and quadrupeds. In fish and reptiles, on the other hand, in which the vital processes are much slower, the temperature is much lower, being, in fact, usually about that of the surrounding air or water in which they live, their heat production being actually too small to en¬ able them to maintain an independent temperature. A French phys¬ iologist experimented upon a marmot a few years ago, and found that when the animal was asleep, its temperature was only about 40° F., while it was 89° F. when awake. In all hibernating animals there is a marked decrease in the temperature while the animal is in a state of hibernation. There is good reason for believing that the friction of the blood in the blood-vessels is an important source of heat. Carefully con¬ ducted experiments show that the force exerted by the heart each twenty-four hours, which is all used up or transformed in the body, is equivalent to more than 1,000 degrees of heat, or sufficient to raise 100 lbs. of water 10° F. in temperature. The fact that heat is pro¬ duced by conversion of the force expended in the circulation, is further shown by a series of experiments made by the eminent French phys¬ iologist, Bernard, for the purpose of ascertaining the temperature of the blood in various parts of the body. He found that the blood of the portal vein and that of the hepatic vein is warmer than that of any other part of the body, that in the hepatic vein showing the high¬ est temperature of all, which is undoubtedly attributable to the fact that the blood of this vein has passed through two sets of capillaries, so that its circulatory force has been almost wholly converted into heat. 316 ANATOMY, PHYSIOLOGY, AND HYGIENE. REPRODUCTION. Believing that ignorance on this subject lies at the root of some of the most serious diseases and the most degrading vices to which human beings are subject, we have not hesitated to introduce it here in order to do our part in enlightening the world with reference to the dangers from a source which, too often unsuspected, pours forth contamination and degradation, blighting the prospects of the most promising, and sparing none who place themselves knowingly or unwittingly within its reach. The greater portion of this chapter is in substance quoted from our work upon the subject entitled, “Plain Facts for Old and Young.” Reproduction is a function common to all animals and to all plants. Every organized being has the power to reproduce itself, or to produce, or aid in producing, other individuals like itself. It is by means of this function that plants and animals increase or multiply. When we consider the great diversity of characters illustrated in animal and vegetable life, and the infinite variety of conditions and cir¬ cumstances under which organised creatures exist, it is not surprising that modes of reproduction should also present great diversity both in general character and in detail. © Simplest Form of Generation. — Deep down beneath the waters of the ocean, covering its bottom in certain localities, is found a curious slime, which, under the microscope, is seen to be composed of minute rounded masses of gelatinous matter, or protoplasm. By watching these little bodies intently for a few minutes, the observer will discover that each is a living creature capable of moving, growing, and assuming a variety of shapes. Continued observation will reveal the fact that these little creatures multiply; and a more careful scrutiny will enable him to see how they increase. Each divides into two equal parts so nearly alike that they cannot be distinguished from each other. In this case the process of generation is simply the production of two similar individuals from one. A small quantity of slime taken from the surface of a stone near the bottom of an old well or at the seaside, when placed under the mi¬ croscope, will sometimes be found to contain large numbers of small, round, living bodies. Careful watching will show that they also mul- SEX. — HERMA PHBODISM. 317 tiply by division ; but before the division occurs, two cells unite to form one by a process called conjugation. Then, by the division of this cell, instead of only two cells, a large number of small cells are formed, each of which may be considered as a bud formed upon the body of the parent cell and then separated from it to become by growth an individual like its parent, and, like it, to produce its kind. In this case, we have new individuals formed by the union of two in¬ dividuals which are to all appearance entirely similar in every par¬ ticular. Sex. — Rising higher in the scale of being, we find that, with rare exceptions, reproduction is the result of the union of two dissimilar elements. These elements do not, in higher organisms, as in lower forms of life, constitute the individuals, but are produced by them ; and being unlike, they are produced by special organs, each adapted to the formation of one kind of elements. The two classes of organs usually exist in separate individuals, thus giving rise to distinctions of sex ; an individual possessing organs which form one kind of ele¬ ments being called a male, and one possessing organs for the forma¬ tion of the other kind of elements, a female. The sexual differences between individuals of the same species are not, however, confined to the sexual organs. In most classes of plants and animals, other sex¬ ual differences are very great. In some of the lower orders of an¬ imals, and in many species of plants, the male and female individuals are so much unlike that for a long time after they were well known, no sexual relation was discovered. Hermaplirodism, — An individual possessing both male and fe¬ male organs of reproduction is called an hermaphrodite. Such a combi¬ nation is very rare among higher animals; but it is by no means uncom¬ mon among plants and the lower forms of animal life. The snail, the oyster, the earth-worm, and the common tape- worm, are examples of true hermaphrodites. So-called human hermaphrodites are usually individuals in whom the sexual organs are abnormally developed so that they resemble those of the opposite sex, though they really have but one sex, which can usually be determined with certainty. Only a very few cases have been observed in which both male and female organs were present. There is now living in Germany an individual who bears the name of a woman; but learned physicians have decided that the person is as much man as woman, having the organs of both sexes. What is 318 RATIONAL REMEDIES FOR DISEASE. still more curious, this person has the feelings of both sexes, having loved at first a man, and afterward a woman. There have been ob¬ served, also, a very few instances of individuals in whom the sexual organs of neither sex were present. It thus appears that a person may be of both sexes or of no sex at all. Sex ill Plants. — To one unacquainted with the mysteries of plant life and growth, the idea of attaching sexuality to plants seems very extraordinary ; but the botanist recognizes the fact that the distinc¬ tions of sex are as clearly maintained in the vegetable as in the ani¬ mal kingdom. The sexual organs of the higher orders of plants are flowers. That part of the flower which produces seeds answers to the female ; another part, which is incapable of forming seeds, answers to the male. The fertile and sterile flowers are sometimes produced on separate plants. Very frequently, they are produced upon separate paits of the same plant, as in the oak, walnut, and many other forest trees, and Indian corn. In the latter plant, so familiar to every one, the “ tassel ” contains the male flowers, and the part known as the “ silk,” with the portion to which it is attached — which becomes the ear — the female or fertile flowers. In a large number of species, the male and female organs are combined in a single flower, making n true hermaphrodite. Sex ill Animals. — As previously remarked, individuals of opposite sex usually differ much more than in the character of their sexual or¬ gans only. Among higher animals, the male is usually larger, stronger, and of coarser structure than the female. The same contrast is ob¬ served in their mental characters. With lower animals, especially in¬ sects, the opposite is often observed. The female spider is many times- larger than the male. The male ant is small in size when compared with the female. Nevertheless, in all classes of animals the difference in the structure and the functions of the sexual organs is the chief distinguishing character. These differences are not so great, however, as they might at first appear. The male and female organs of repro¬ duction in man and other animals, which seem so dissimilar, when studied in the light shed upon this subject by the science of embryol- ogy, are found to be wonderfully alike in structure, differing far more in appearance than in reality, and being little more than modifications of one general plan. Every organ to be found in the one sex has an analogue in the other which is complete in every particular, correspond¬ ing in function, in structure, and usually in position. SEXUAL DIFFERENCES. 319 Other Sexual Differences.— In this country there is between five and six inches difference in height and about twenty pounds difference in weight between the average man and the average woman, the aver- age man being about five feet, eight inches in height, and weighino1 one hundred and forty-five pounds ; while the average woman is five feet, two or two and one-half inches in height, and weighs one hun¬ dred and twenty-five pounds. The relation of the sexes in height and weight varies in degree in different countries, but is never changed. The average height and weight of American men and women is above that of the average human being. © © Men and Women Differ in Form. — The differences in form are so marked that it is possible for the skilled anatomist to determine the sex of a human being who has been dead for ages, by an examination of the skeleton alone. In man, the shoulders are broad, the hips nar¬ row, and the limbs nearly straight with the body. In woman, the shoulders are narrow and usually rounded, and set farther back, the collar-bone being longer and less curved, giving the chest greater prominence ; while the hips are broad. The consequence of these differences is that woman is generally less graceful and naturally less skillful in the use of the extremities than man, and hence less fitted for athletic sports and feats requiring great dexterity. A girl throws a stone awkwardly, less from want of practice than from a natural peculiarity of physical structure. A woman walks less gracefully than a man, owing to the greater relative breadth of her hips, requiring a motion of the body together with that of the limbs. In consequence of this peculiarity, a woman is less fit¬ ted for walking long distances. The Male and the Female Brain. — But there are other important physical differences to which we must call attention. Man possesses a larger brain than woman, but she makes up the deficiency in size by superior fineness in quality. The female brain differs from the mas¬ culine organ of mentality in other particulars so marked that one who has given the subject attention can determine with perfect ease the probable sex of the owner of almost any skull which might be pre¬ sented to him. This difference in the conformation of the skull is un¬ doubtedly due to a difference in mental character, which, in turn, de¬ pends upon a difference in cerebral development. Vital Organs of Man and Woman. — The anatomist also observes an interesting difference in the size of the various vital organs. For 320 ANATOMY, PHYSIOLOGY , AND HYGIENE . example, while a woman has a heart proportionally smaller than the same organ in man, she has a larger liver. Thus, while less well fitted for severe physical exertion by less circulatory power, she has superior excretory powers. This peculiarity of structure is perfectly harmonious with the fact which experience has established so often as to make the matter no longer a question, that woman is less fitted for severe muscular exer¬ tion than man, but possesses in a superior degree the quality known as endurance. With a less robust frame, a more delicately organized constitution, she will endure for months what would kill a robust man in as many weeks. More perfect elimination of the wastes of the body secures a higher grade of vitality. On no other hypothesis could we account for the marvelous endurance of the feminine part of the civilized portion of the human race, ground down under the heel of fashion for ages, “ stayed,” “ corseted,” “ laced,” and thereby distorted and deformed in a manner that would be fatal to almost any member of the masculine sex. The Reproductive Elements. — As has been previously observed, in all except the very lowest forms of life, two elements are necessary to the production of a new individual, or a reproduction of the species, — a male element and a female element. The special organs by means of which these elements are produced, brought together, and developed into the new individual in a more or less perfect state, are termed sexual or¬ gans, as we have already seen. As an introduction to the specific study of the sexual organs in the human species, let us briefly consider the — Sexual Orgaus of Plants. — As already remarked, flowers are the sexual organs of plants. Nothing is more interesting in the natural world than the wonderful beauty, diversify, and perfect adaptability to various conditions and functions, which we see in the sexual parts of plants. An exceedingly interesting line of study, which has occupied the attention of many naturalists, is the wonderful perfection displayed in the adaptability of the male and female parts of plants to each other. Without burdening the reader with unnecessary technicalities of detail, we will briefly notice the principal parts of vegetable sexual organs as illustrated in flowers. Complete flowers are made up of four parts, two of which, the stamen and pistil, are essential, while the other two, the calyx and corolla, are accessory. The calyx is that part which surrounds the flower at its outer and SEXUAL ORGANS OF ANIMALS. 321 lower part. It varies greatly in form and color, but is most frequently of a green or greenish color. Just within the calyx is the co¬ rolla, which usually forms the most attractive, showy, and beautiful part of the flower. The beautifully col¬ ored petals of the rose, geranium, dahlia, and similar flowers, form their corollas. In Fig. 134 is given a diagramatic view of the various parts of a perfect flower. Sexual Organs of Animals. — The male reproductive element is called a spermatozoon or zoosperm. The female element is called an ovum, literally, an egg. A spermatozoon somewhat resem¬ bles a tadpole in appearance, having, however, a much longer tail in pro¬ portion to the size of the body, as will be seen by reference to Fig. 135. Human spermatozoa are about -5-5-^ of an inch in length. Those of reptiles are very much larger. One of the remarkable features of these minute elements is their peculiar movements. While alive, the fila¬ mentous tail is in constant action in a manner strongly resembling the movements of the caudal appendage of a tadpole. This wonderful prop¬ erty led the earlier observers to be¬ lieve that they were true animalcu- la. But they are not to be regarded as such, though one can scarcely make himself believe otherwise while watching their lively evolutions, and apparent volitionary movements from one point to another. 21 Fig:. 134. a. Ovary; b. Pistil; c c. Stamens and Anthers ; d. Cor¬ olla; e. Calyx. Fig;. 135. a. Human Spermatozoa; b. Spermatozoa of the rat ; C. Spermatozoa of Menobrauchus. (Dalton.) 322 ANATOMY, PHYSIOLOGY, AND HYGIENE. In man the formation of spermatozoa continues with greater or less rapidity from puberty to old age, though at the two extremes of existence they are imperfectly developed. When not discharged from the body, they are said to be absorbed. Some physiologists claim that they are composed of a substance identical with nerve tissue, and that by absorption they play a very important part in the development and maintenance of the nervous system. It is asserted by good authorities that the reproductive element in man is not so well developed as to be really fit for the reproduction of the species before the age of twenty-four or twenty-five. After the age of forty-five or fifty, the reproductive elements deteriorate in quality, and become again unfitted for vigorous procreation. The Ovum. — Fig. 136. The female ele¬ ment of generation, the ovum, is produced by an organ called the ovary, of which there are two in each individual. The human ovum varies in size from -giir to of an inch in diameter, and consists of a single cell. Ova are not formed in such large numbers as zoos¬ perms. As a general rule, in the human fe¬ male, a single ovum is developed and dis¬ charged once in about four weeks, during the period of sexual activity. Fecundation. — It is often asked, and the question has elicited some discussion, Which is the principal reproductive element ; the zoosperm, or the ovum ? The ancients supposed the male element to be the essential element, being simply nourished and developed by the female ; but modern research in biological science does not sus¬ tain this view. Probably neither one enjoys especial preeminence; for neither can undergo complete development without the other. In very rare cases, the ovum has been observed to undergo a certain amount of development of itself ; but a perfect individual can be pro¬ duced only by the union of the two kinds of elements, which process is known as fecundation. The instant this union occurs, the life of a new individual begins. All the changes which result between that moment and the birth of the individual are those of development only. Indeed, the same existence continues from the instant of the union of the two elements, not only until birth, but through growth, the attainment of maturity, the decline of life, and even until death. Fig. 136. Human Ovum, magnified one hundred and thirty diameters. (Dalton.) MODES OF FECUNDATION. 323 It is interesting to observe the different methods by which fecun¬ dation is effected, botli in plants and animals, for this is a process com¬ mon to both. Fecundation in Flowers. — The great naturalist, Linnaeus, was the first to explain the reproductive process in plants. He tells us that “ the flower forms the theater of their amours ; the calyx is to be considered as the nuptial bed ; the corolla constitutes the curtains ; the anthers are the testes; the pollen, the fecundating fluid; the stigma of the pistil, the external genital aperture ; the style, the vag¬ ina, or the conductor of the prolific seed ; the ovary of the plant, the womb ; the reciprocal action of the stamens on the pistil, the accessory process of fecundation.” Modes of Fecundation in Animals. — The modes by which fec¬ undation is effected in animals are still more various and wonderful than in plants. In some of the lower animals, as in most fish and rep¬ tiles, both elements are discharged from the bodies of the parents be¬ fore coming in contact, there being no contact of the two individuals. In this class of animals the process is almost wholly analogous to fec¬ undation in those plants in which the male and female flowers are on different plants or different parts of the same plant. In the female fish, a large number of ova are developed at a certain season of the year known as the spawning season. Sometimes the number reaches many thousands. At the same time, the testicles of the male fish, which are contained within the abdominal cavity, become distended with developed zoosperins. When the female seeks a place to deposit her eggs, the male closely follows ; and as she drops them upon the gravelly bottom, he discharges upon them the zoosperms by which they are fecundated. The process is analogous to that observed in some species of frogs. When the female is about to deposit her eggs, the male mounts upon her back and rides about until the eggs are all deposited, discharging upon them the fertilizing spermatozoa as they are laid by the female. Development. — After the union of the two elements, known as fecundation or conception , if the conditions are favorable, development occurs, and the little germ is in due process of time developed into an individual which is an exact counterpart of its parents. During this developmental process, the embryonic being is variously treated by different classes of animals. 324 ANATOMY, PHYSIOLOGY, AND HYGIENE. Unprotected Development, — Most fishes and reptiles discharge their ova before fecundation, or soon after, and pay no further atten¬ tion to them. The fish deposits its eggs in a little hollow scooped out in the gravelly bed of a stream, or sows them broadcast upon the wa¬ ters. The turtle buries its eggs in the sand, and leaves them to be hatched by the sun. The ostrich disposes of her eggs in the same way. Many other species of animals pay no regard to the protection of the germs which are destined, if placed under favorable conditions, to become individuals like themselves. Development in the Higher Animals and Man.— Higher ani¬ mals are less prolific, and their development is a more complicated proc¬ ess ; hence, their young need greater protection, and, for this reason, the ova, instead of being discharged from the body of the female after fecundation, are retained.* As we have seen that a suitable re¬ ceptacle is sometimes provided outside of the body, so now a recepta¬ cle is needed, and is provided in the interior of the body of the female. This receptacle is called — The Uterus. — This is a hollow, pear-shaped organ, located in the median line, just behind the bladder, between it and the rectum. It is supported in place by various ligaments and by the juxtaposition of other organs. Its larger end is directed upward, and communicates upon each side with a very narrow tube which is prolonged outward on either side until it nearly touches the ovary of the same side. When an ovum is matured, it escapes from the ovary into the nar¬ row tube referred to, called the Fallopian tube , and passes down into the cavity of the uterus. If fecundation does not occur, it is expelled or absorbed after six to twelve or fourteen days. Uterine Gestation. — This is the term applied to the process last referred to. We shall not attempt to describe in detail this most won¬ derful and intricate of all living processes; but will sketch only the chief points, leaving the reader who would obtain a more complete knowledge * Curious examples of internal development sometimes occur in animals which usually deposit eggs. Snakes have been known to produce both eggs and living young at the 6ame time. At the annual meeting of the American Society for the Advancement of Science, at Detroit, Mich., in August, 1875, we had the pleasure of examining a specimen, exhibited by Prof. Wilder, of a chick which had undergone a considerable degree of development within the ovary of the hen. It had a head, a rudimentary brain, and internal viscera, but no feathers nor limbs. It was, in fact, an egg hatched before it had been laid. This anomaly excited much iuterest at that time and since among biologists. THE PRIMITIVE TRACE. 325 of the subject to consult any one of the numerous physiological and ob¬ stetrical works which deal with it in a very exhaustive manner. As soon as the ovum is impregnated by the male element, it begins a process of sym¬ metrical division. The first division pro¬ duces two cells out of the single one which first existed. By the next division, four seg¬ ments are produced; then eight, sixteen, etc. Fig. 137. While this process is go¬ ing on, the ovum becomes adherent to the internal wall of the uterus, and is soon en¬ veloped by its mucous membrane, which grows up about and incloses it. The Primitive Trace. — When the proc¬ ess of segmentation has advanced to a cer¬ tain point, the cells are aggregated together in a compact layer at the surface. Soon a straight line appears upon this layer, which is called the primitive trace. Fig. 138. This delicate line becomes the basis for the spinal column ; and upon and about it the whole individual is developed by an intricate process of folding } dividing, and reduplica- Fig-. 137. Diagram illustrating the segmentation of the Ovum. Fig-. 138. The Human Ovum after fecundation, showing primitive trace. tion of the layer of cells. One end of the line becomes the head, and the other becomes the tail. Even man has a caudal appendage at an early stage of his existence. After a further lapse of time, little excres¬ cences, buds, or “ pads,” appear in the proper positions to represent the arms and legs. After further development the ends split up into fin- 3*26 ANATOMY, PHYSIOLOGY, AND HYGIENE. gers and toes, and by the continued development of the parts, perfect arms and legs are formed. Curious Relation to Lower Animals.— It is a very remarkable fact that in the lower animals we have numerous examples in which the permanent condition of the individual is the same as some one of the stages through which man passes in the process of development. An eminent author makes the following interesting statements: — “ The webbed feet of the seal and ornithorhynchus typify the period when the hands and feet of the human embryo are as yet only partly subdivided into fingers and toes. Indeed, it is not uncommon for the * web ’ to persist to some extent between the toes of adults ; and occa¬ sionally children are born with two or more fingers or toes united to their tips. “ With the seal and the walrus, the limbs are protruded but little beyond the wrist and ankle. With the ordinary quadrupeds, the knee and elbow are visible. The cats, the lemurs, and the monkeys form a series in which the limbs are successively freed from the trunk, and in the highest apes they are capable of nearly the same movements as the human arm and leg, which, in their development, passed through all these stages.” Simplicity of Early Structures. — The first structures formed are exceedingly simple in form. It is only by slow degrees that the great complexity which characterizes many organs is finally attained. For example, the heart is at first only a straight tube. By enlarge¬ ment and the formation of longitudinal and transverse partitions, the fully developed organ is finally produced. The stomach and intes¬ tines are also at first but a simple straight tube. The stomach and large intestine are formed by dilatation; and by a growth of the tube in length while the ends are confined, the small intestines are formed. The other internal organs are successively developed by similar processes. The Stages of Growth . — At first insignificant in size, — a simple cell, — the embryonic human being steadily increases in size, gradually approximating more and more closely to the human form, until, at the end of about nine calendar months, or ten lunar months, the new individual is prepared to enter the world and begin a more independ¬ ent course of life. The following condensation of a summary quoted by Dr. Austin Flint, Jr., will give an idea of the size of the develop¬ ing being at different periods, and the rate of progress : — DURATION OF GESTATION. 327 At the end of the third week, the embryon is a little less than one-fourth of an inch in length. At the end of the seventh week, it is three-fourths of an inch long. The liver, lungs, and other internal organs are partially formed. At the eighth week, it is about one inch in length. It begins to look some like a human being, but it is impossible to determine the sex. At the third month, the embryon has attained the length of two to two and one-half inches. Its weight is about one ounce. At the end of the fourth month, the embryon is called a fetus. It is from four to five inches long, and weighs five ounces. At the fifth month, the fetus is nearly a foot long, and weighs about half a pound. At the sixth month, the average length of the fetus is about thir¬ teen inches, and its weight one and a half to two pounds. If born, life continues but a few minutes. At the seventh month, the fetus is from fourteen to fifteen inches long, and weighs two to three pounds. It is now viable (may live if born). At the eighth month, the length of the fetus is from fifteen to six¬ teen inches, and its weight from three to four pounds. At the ninth month, the fetus is about seventeen inches long, and weighs from five to six pounds. At birth, the infant weighs a little more than seven pounds, the usual range being from four to ten pounds, though these limits are sometimes exceeded. Duration of Gestation. — The length of time required for the de¬ velopment of a human being is usually reckoned as about forty weeks. A more precise statement places it at about two hundred and seventy-eight days. This limit is often varied from. Cases have oc¬ curred in which a much longer time has been required, and number¬ less cases have occurred in which human beings have been born sev¬ eral weeks before the expiration of the usual time, as stated. There is some uncertainty respecting the exact length of the period of gesta¬ tion, which grows out of the difficulty of determining, in many cases, the exact time when conception takes place. Uterine Life. — The uterine life of the new individual begins with the impregnation of the ovum, which occurs the instant it is 328 ANATOMY, PHYSIOLOGY, AND HYGIENE. brought in contact with the zoosperms of the male. While in the uterus, the young life is supported wholly by the mother. She is obliged to provide not only for her own sustenance, but for the main¬ tenance of her child. And she must not only eat for it, but breathe for it as well, since it requires a constant and adequate supply of oxy¬ gen before birth as much as afterward. How the Unborn Infant Breathes. — Oxygen and nutriment are both supplied to it through the medium of an organ called the pla¬ centa, which is a spongy growth composed almost entirely of blood¬ vessels, and is developed upon the inner wall of the uterus, at the point at which the ovum attaches itself after fecundation. The grow¬ ing fetus is connected with this vascular organ by means of a sort of cable, called the umbilical cord. The cord is almost entirely com¬ posed of blood-vessels, which convey the blood of the fetus to the pla¬ centa and return it again. The fetal blood does not mix with that of the mother, but receives oxygen and nourishment from it by ab¬ sorption through the thin walls which alone separate it from the mother’s blood. The umbilical cord contains no nerves, as there is no nervous con¬ nection between the mother and the child. The only way in which the child can be influenced by the mother is through the medium of the blood, to changes in which it is very susceptible, as we shall see more clearly hereafter. The cord is attached to the body of the child at the point called the navel, being cut off' at birth by the accoucheur. With the pla¬ centa, it is expelled soon after the birth of the child, and constitutes the shapeless mass familiarly known as the after-birth, by the reten¬ tion of which the most serious trouble is occasionally caused. Parturition. — At the end of the period of development, the young being is forcibly expelled from the laboratory of nature in which it has been formed. In other words, it is born ; and this proc¬ ess is termed parturition. Though, at first thought, such an act would seem an utter impossibility, yet it is a very admirable illustra¬ tion of nature’s adaptation of means to ends. During the months of gestation, while the uterus has been enlarging to accommodate its daily increasing contents, the generative passages have also been in¬ creasing in size and becoming soft and distensible, so that a seeming impossibility is in due time accomplished without physical damage, CHANGES IN THE CHILD AT BIRTH. 329 though possibly not without intense suffering. However, it is a most gratifying fact that modern medical science may do much to mitigate the pains of childbirth. It is possible, by a proper course of prepara¬ tion for the expected event, to greatly lessen the suffering usually undergone ; and some ladies assert that they have thus avoided real pain altogether. Although the curse pronounced upon the feminine part of the race, in consequence of the sin of Eve, implies suffering in the parturient act, yet there is no doubt that the greater share of the daughters of Eve are, through the perverting and degenerating influ¬ ences of wrong habits and especially of modern civilization, compelled to suffer many times more than their maternal ancestor. We have sufficient evidence of this in the fact that among barbarian women, who are generally less perverted physically than civilized women, childbirth is regarded with very little apprehension, since it occasions little pain or inconvenience. The same is true of many women among the lower laboring classes. In short, while it is true that more or less suffering must always accompany parturition, yet the excessive pain usually attendant upon the process is the result of causes which can in many cases be removed by proper management beforehand and at the time of confinement. After being relieved of its contents, the uterus and other organs rapidly return to nearly their original size. Changes in the Child at Birth . — In the system of the child a wonderful change occurs at the moment of its expulsion into the outer world. For the first time, its lungs are filled with air. For the first time, they receive the full tide of blood. The whole course of the circu¬ lation is changed, and an entirely new process begins. It is surprising in how short a space of time changes so marvelous can be wrought. Nursing. — The process of development is not fully complete at birth. The young life is not yet prepared to support itself ; hence, still further provision is necessary for it. It requires prepared food suited to its con¬ dition. This is provided by the mamma, or breasts, of the female, which are glands for secreting milk. The fully developed gland is peculiar to the female ; but a few instances have been known in which it has been sufficiently developed to become functionally active in men, as well as in young girls, though it is usually inactive even in women until near the close of gestation. It is a curious fact that the breasts of a new-born child occasionally contain milk. The first product of the mamnue is not the proper milk secretion, 330 ANATOMY, PHYSIOLOGY, AND HYGIENE. but is a yellowish fluid called colostrum. The true milk secretion le- gins two or three days after delivery. The lacteal secretion is influenced in a very remarkable manner by the mental conditions of the mother. By sudden emotions of grief or anger, it has been known to undergo such changes as to produce in the child a fit of indigestion, vomiting, diarrhea, and even convulsions and death. Any medicine taken by the mother finds its way into the milk, and often affects the delicate system of the infant more than herself. This fact should be a warning to those nursing mothers who use stimu¬ lants. Cases are not uncommon in which delicate infants are kept in a state of intoxication for weeks by the use of alcoholic drinks by the mother. The popular notion that lager-beer, ale, wine, or alcohol in any other form, is in any degree necessary or beneficial to a nursing woman is a great error which cannot be too often noticed and condemned. Not only is the mother injured, instead of being benefited, by such a practice, but great injury, sometimes life-long in its consequences, is inflicted upon the babe at her breast that takes the intoxicating poison at second hand, and is influenced in a fourfold degree from its feebleness and great susceptibility. Puberty. — For a certain period after birth, the sexual organs re¬ main in a partially developed condition. This period varies in duration with different animals ; in some cases being very brief, in others, com - prising several years. Upon the attainment of a certain age, the indi¬ vidual becomes sexually perfect, and is then capable of the generative act. This period is called puberty. In man, puberty commonly occurs between the ages of ten and fifteen years, varying considerably in differ¬ ent climates. In this country, and in other countries of about the same latitude, puberty usually occurs at the age of fourteen or fourteen and one-half years in females, and a few months later in males. In cooler climates, as in Norway and Siberia, the change is delayed to the age of eighteen or nineteen years. In tropical climates it is hastened, occurring as early as nine or ten years. In warm climates it is no uncommon thing for a girl to be a mother at twelve ; and it is stated that one of the wives of Mahomet was a mother at ten. Other causes besides climate tend to hasten the occurrence of this change, as habits, temperament, constitutional tendency, education, and idiosyncrasy. Habits of vigorous physical exercise tend to delay the access of pu¬ berty. For this reason, together with others, country boys and girls gen- INFLUENCE OF DIET ON PUBERTY. 331 erally mature later by several months, and even a year or two, than those living in the city. Anything that tends to excite the emotions hastens puberty. The excitements of city life, parties, balls, theaters, even the competition of students in school, and the various causes of excitement to the nervous system which occur in city life, have a tendency to hasten the occurrence of the change which awakens the sexual activities of the system into life. Hence, these influences cannot but be considered prej¬ udicial to the best interests of the individual, mentally, morally, and physically, since it is in every way desirable that a change which arouses the passions and gives to them greater intensity should be delayed rather than hastened. Influence of Diet on Puberty. — The dietary has a not unimpor¬ tant influence in this respect. Stimulating food, such as pepper, vinegar, mustard, spices, and condiments generally, together with tea and coflee, and an excess of animal food, have a clearly appreciable influence in in¬ ducing the premature occurrence of puberty. On this account, if on no other, should these articles be prohibited to children and youth, or used very sparingly. Those who advocate the large use of meat by children and youth have not studied this matter closely in all its bearings. While it is true that children and growing youth require an abundance of the nitrogenous elements of food, which are found abundantly in beefsteak, mutton, fish, and other varieties of animal food, it is also true that in taking those articles of food they take along with the nutrient elements properties of a stimulating character, which exert a decidedly detrimental influence upon the susceptible systems of children and youth. At the same time, it is possible to obtain the same desirable nitrogenous ele¬ ments in oatmeal, unbolted wheat flour, peas, beans, and other vegetable productions, which are wholly free from injurious properties. We are positive from numerous observations on this subject, that a cool, unstim¬ ulating, vegetable or farinaceous diet would deter the development of the sexual organism for several months, and perhaps for a year or two. While it may not be in all cases desirable to do this, it would at least be wise to adopt such measures in cases in which the child is unavoida¬ bly exposed to influences which have a tendency to hasten the change. It is important to add in this connection a word of caution against the adoption of a dietary too abstemious in character. It is necessary that an abundance of good, wholesome food, rich in the elements of nu¬ trition, should be taken regularly. There is no doubt that many young ladies have induced conditions of serious disease by actual starvation of 332 ANATOMY, PHYSIOLOGY, AND HYGIENE. the system. A young woman who attempts to live on strong tea or coffee, fine-flour bread, and sweet-cake, is as certainly starving herself as though she were purposely attempting to commit suicide by means of starvation, and with as much certainty of the same result. Cases occasionally occur in which puberty makes its appearance at the age of three or four years. Indeed, a case has been reported in this country in which a female child possessed all the characteristics which are usually developed at puberty, from birth. In this case the regular periodical changes began at birth. Premature Development Occasions Early Decay. — A fact which is of too great importance to allow to pass unnoticed, is that whatever occasions early or premature sexual development, also occasions prema¬ ture decay. Females in whom puberty occurs at the age of ten or twelve, by the time this age is doubled, are shriveled and wrinkled with age. At the time when they should be in their prime of health and beauty, they are prematurely old and broken. Those women who mature late retain their beauty and their strength many years after their precocious sisters have become old, decrepit, and broken down. Thus, the matrons of thirty and forty years in colder climates are much more attractive in appearance than the maidens of sixteen ; while quite the reverse is true in this and other countries where sexual development is unduly hastened. The unnaturally early appearance of puberty is a just cause for ap¬ prehension, since it usually indicates an inherent weakness of the consti¬ tution. When there are reasons for fearing its occurrence, active meas¬ ures should be taken to occasion delay if possible. We call especial at¬ tention to this point, since there are many who erroneously suppose the early occurrence of puberty to be a sign of superior vigor. Changes which Occur at Puberty. — The changes which occur in the two sexes at this period have been thus well described : — “ In both sexes, hair grows on the skin covering the symphysis pubis, around the sexual organs, and in the axillae (armpits). In man, the chest and shoulders broaden, the larynx enlarges, and the voice becomes lower in pitch from the elongation of the vocal cords ; hair grows upon the chin, upper lip, and cheeks, and often exists upon the general sur¬ face of the body more abundantly than in woman.” The sexual organs undergo enlargement, and are more frequently excited. The testicles first begin the secretion of the seminal fluid. © “ In woman, the pelvis and abdomen enlarge, but the whole frame CHANGES WHICH OCCUR AT PUBERTY. 333 remains more slender, the muscles and joints less prominent, the limbs more rounded and tapering [than in the male]. Locally, both external and internal organs undergo a considerable and rapid enlargement. The mammse enlarge, the ovarian vesicles become dilated, and there is es¬ tablished a periodical discharge of one or more ova, accompanied, in most cases, by a sanguineous fluid from the cavity of the uterus.” These changes, so varied and extraordinary, often occur within a very short space of time ; and as they are liable to serious derangement, especially in the female, great care should be taken to secure for the in¬ dividual the most favorable conditions until they are successfully effected. It is, however, a fact deserving of mention, that many of the ills which are developed at this particular period are quite as much the result of previous indiscretions and mismanagement as of any immediate cause. A few suggestions with regard to the proper treatment of individuals at this age may be in place. 1. Do not allow the boy or girl to be overworked, either mentally or physically. Great and important changes are occurring within the body, and nature should not be overtaxed. 2. Keep the mind occupied. While excessive labor should be avoided, idleness should be as carefully shunned. Some light, useful employment or harmless amusement — better some kind of work — should keep the mind fully occupied with wholesome subjects. 3. Abundant exercise out-of-doors is essential for both sexes. Sun¬ shine and fresh air are as necessary to the development of a human be¬ ing as for the expanding of a flower , bud. 4. Watch carefully the associations of the youth. This should be done at all times, but especially just at the critical period in question, when the general physical disturbances occurring in the system react upon the mind and make it peculiarly susceptible to influences, especially those of an evil character. 5. None too much care can be exercised at this important epoch of human life, provided it is properly applied ; but nothing could be more disastrous in its consequences than a weak solicitude which panders to every whim and gratifies every perverted appetite. Such care is a fatal error. Menstruation. — The functional changes which occur in the female are much more marked than those of the male. As already intimated, the periodical development and discharge of an ovum by the female, which occurs after puberty, is accompanied by the discharge of a bloody 334 ANATOMY, PHYSIOLOGY, AND HYGIENE. fluid, which is known as the flowers, menses, or catamenia. The ac¬ companying symptoms together are termed the process of menstruation, or being unwell. This usually occurs, in the human female, once in about four weeks. In special cases, the interval may be a week less or a week longer ; or the variation may be even greater. Dalton describes the process as follows : — “ When the expected period is about to come on, the female is affected by a certain degree of discomfort and lassitude, a sense of weight in the pelvis, and more or less disinclination to society. These symptoms are in some cases slightly pronounced, in others more troublesome. An un¬ usual discharge of vaginal mucus then begins to take place, which soon becomes yellowish or rusty brown in color, from the admixture of a certain proportion of blood ; and by the second or third day, the dis¬ charge has the appearance of nearly pure blood. The unpleasant sensa¬ tions which were at first manifest, then usually subside ; and the dis¬ charge, after continuing for a certain period, begins to grow more scanty. Its color changes from a pure red to a brownish or rusty tinge, until it finally disappears altogether, and the female returns to her ordinary condition.” The menstrual function continues active from puberty to about the forty-fifth year, or during the period of fertility. When it finally dis¬ appears, the woman is no longer capable of bearing children. The time of disappearance is termed the “ change of life,” or menopause. Ex¬ ceptional cases occur in which this period is greatly hastened, arriving as early as the thirty-fifth year, or even earlier. Instances have also been observed in which menstruation continued as late as the sixtieth year, and even later ; but such cases are very rare ; and if procreation occurs, the progeny is feeble and senile. With rare exceptions, the function Is suspended during pregnancy, and usually, also, during the period of nursing. Nature of Menstruation. — There has been a great amount of spec¬ ulation concerning the cause and nature of the menstrual process. No entirely satisfactory conclusions have been reached, however, except that it is usually accompanied by the maturation and expulsion from the ovary of an ovum, which is termed ovulation. But menstruation may occur without ovulation, and vice versa. Menstruation is not peculiar to the human female, being represented in the higher animals by what is familiarly termed the “ rut.” This is not usually a bloody discharge, however, as in the human female, though such a discharge has been observed in the monkey. IMPORTANT HINTS. 335 It has been quite satisfactorily settled that the discharge of the ovum from the ovary generally takes place about the time of the cessa¬ tion of the flow. Immediately after the discharge, the sexual desires of the female are more intense than at other times. This fact is particu¬ larly manifest in lower animals. The following remark by Prof. Dalton is especially significant to those who care to appreciate its bearing: — “ It is a remarkable fact, in this connection, that the female of these [domestic] animals will allow the approaches of the male only during and immediately after the oestrual period [rut]; that is, just when the egg is recently discharged, and ready for impregnation. At other times, when sexual intercourse would be necessarily fruitless, the instinct of the animal leads her to avoid it ; and the concourse of the sexes is ac¬ cordingly made to correspond in time with the maturity of the egg and its aptitude for fecundation.” The amount of fluid lost during the menstrual flow varies greatly with different individuals. It is estimated at from three ounces to half a pint. In cases of deranged function, it may be much greater than this. It is not all blood, however, a considerable portion being mucus. It is rather difficult to understand why the discharge of so considerable a quantity of blood is required. There is no benefit derived from a very copious discharge, as some suppose. Facts seem to indicate that in gen¬ eral those enjoy the best health who lose but small quantities of blood in this manner. As the first occurrence of menstruation is a very critical period in the life of a female, and as each recurrence of the function renders her especially susceptible to morbid influences, and liable to serious derange¬ ments, a few hints respecting the proper care of an individual at these periods may be acceptable. Important Hints. — 1. Avoid taking cold. To do this, it is neces¬ sary to avoid exposure ; not that a person must be constantly confined in a warm room, for such a course would be the surest way in which to increase the susceptibility to cold. Nothing will disturb the men¬ strual process more quickly than a sudden chilling of the body when in a state of perspiration, or after confinement in a warm room, by exposure, without sufficient protection, to cold air. A daily bath and daily exercise in the open air are the best known means of preventing colds. 2. Intense mental excitement, as well as severe physical labor, is to be sedulously avoided during this period. At the time of its first 336 ANATOMY, PHYSIOLOGY , AND HYGIENE. occurrence, special care should be observed in this direction. Intense study, a fit of anger, sudden grief, or even great merriment, will some¬ times arrest the process prematurely. The feeling of malaise which usually accompanies the discharge is by nature intended as a warning that rest and quiet are required ; and the hint should be followed. Every endeavor should be made to keep the individual comfortable, calm, and cheerful. Feelings of apprehension arising from a contin¬ ual watching of symptoms are very depressing, and should be avoided by occupying the mind in some agreeable manner not demanding se¬ vere effort, either mental or physical. There is no doubt that many young women have permanently in¬ jured their constitutions while at school by excessive mental taxation during the catamenial period, to which they were prompted by ambi¬ tion to excel, or were compelled by the “ cramming ” system too gen¬ erally pursued in our schools, and particularly in young ladies’ semi¬ naries. It is not to be supposed, however, that the moderate amount of sound study required by a correct system of teaching would be in¬ jurious to a healthy young woman at any time, and we have no doubt that a very large share of the injury which has been attributed to over-study during the catamenia has been induced by other causes, such as improper dress, exposure to taking cold, keeping late hours, and improper diet. If there is any class of persons deserving of pity it is that large class of girls and young women who are in every large city employed as clerks, seamstresses, flower-makers, and in other taxing and confin¬ ing occupations. In order to keep their situations they are required to be on hand daily, being allowed no opportunity for rest at the men¬ strual period. In many cases, too, they are compelled to remain upon their feet all day behind a counter, or at a work table, even at periods when a recumbent position is actually demanded by nature. There should be less delicacy in relation to this subject on the part of young women, and more consideration on the part of employers. Here is a field for philanthropic labor which is well worthy of the best efforts of any person of influence who will engage in it. Custom of Indian Women. — The ease with which Indian women perform the parturient act is proverbial. They suffer scarcely at all from the pains of childbirth ; and without doubt one reason of this is the preservation of their sexual health by rest during the menstrual period. At those seasons they invariably absent themselves from the IMPORTANT HINTS. 337 lodge, and enjoy absolute rest. We may readily suppose, from the nature of some of the Mosaic laws, that a custom somewhat similar prevailed among the ancient Hebrew women. If the hardy women of the forest are benefited by rest, certainly our more delicate females may be thus benefited. All need a degree of rest ; with some it should be absolute. The reckless manner in which some young women treat themselves at the menstrual period, is quite appalling to one who is acquainted with the painful and inveterate character of the evils which arise from such abuse. It is no uncommon thing for yOung ladies to attend balls, visit skating rinks, and otherwise expose themselves to in¬ fluences in every way the best calculated to do them the most harm at this particular period, observing not the slightest precaution. Such recklessness is really criminal ; and the sad consequences of physical transgression are sure to follow. A young lady who allows herself to get wet or chilled, or gets the feet wet, just prior to or during men¬ struation, runs the risk of imposing upon herself life-long injury. Mothers should look carefully after their daughters at these periods, and impress upon them the importance of special care. 3. A third hint, which is applicable to both sexes and at all times, is the necessity of attending promptly to the demands of nature for relief of the bowels and bladder. School-girls are often very negli¬ gent in this respect ; and we have seen the most distressing cases of disease which were entirely attributable to this disregard of the promptings of nature. Obstinate constipation and chronic irritation of the bladder are common effects. When constipation results, purga¬ tives in the shape of pills, salts, or “ pleasant purgative pellets,” are resorted to with the certain result of producing only temporary relief, and permanent damage. To escape these evil consequences, do this: 1. Establish a regular habit of relieving the bowels daily at a certain hour ; 2. Discard laxa¬ tive and cathartic drugs of every kind; 3. To aid in securing a regu¬ lar movement of the bowels, make a liberal use of oatmeal, wheat- meal, fruit, and vegetables, avoiding fine-flour bread, sweetmeats, and condiments; 4. Take daily exercise, as much as. possible short of fa¬ tigue ; if necessarily confined in-doors, counteract the constipating in¬ fluence of sedentary habits by kneading and percussing the bowels with the hands several minutes each day ; 5. Never resist the calls of nature a single moment, if possible to avoid it. In this case, as in 338 ANATOMY, PHYSIOLOGY, AND HYGIENE. numerous others, “ delay is dangerous.” Ladies who desire a sweet breath — and what lady does not — should remember that retained feces are one of the most frequent causes of foul breath. The foul odors which ought to pass out through the bowels find their way into the blood and escape at the lungs. It is of the greatest importance that careful attention should be given to the proper establishment of the menstrual function at the outset of a woman’s life of sexual activity. The first two years will be quite likely to have a deciding influence respecting her health dur¬ ing her whole future life. If a woman can get through the first two years after puberty without acquiring any serious uterine or ovarian disease, she will stand a good chance of enjoying a good degree of sex¬ ual health during the balance of her life. The foundation of a great share of the many thousands of cases of uterine disease is laid during this period. At this early period the daughter is usually too young to appreci¬ ate the importance of observing slight deviations from the standard of health, even if she were able to recognize them. Hence it is a duty which no mother should neglect, to inquire into the exact fre¬ quency of the periods, the amount and character of the discharge, and other points necessary to ascertain whether or not there is any devia¬ tion from the natural condition of health. If there is pain, it is a cer¬ tain evidence of something seriously wrong. If there is irregularity in any particular, it is a matter well deserving of serious attention. Extra-Uterine Pregnancy. — Sometimes the ovum becomes fec¬ undated before reaching the uterus, and instead of passing onward into that organ as usual, remains in its position in the Fallopian tube or even on the surface of the ovary. Occasionally an ovum falls into the cavity of the abdomen instead of passing into the tube. Even in this situation it may be fecundated. Impregnated ova, thus left in abnormal positions, sometimes undergo a greater or lesser degree of de¬ velopment. They often result in the death of the mother. Twins. — The human female usually matures but one ovum at each menstrual period, the two ovaries acting alternately. Occasionally two ova are matured at once. If fecundation occurs, the result will be a development of two embryos at the same time. In rare cases, three or even four ova are matured at once, and by fecundation pro¬ duce a corresponding number of embryos. As many as five children have been born alive at one birth, but have not usually lived more than a few minutes. MONSTERS. 339 Monsters. — Defects and abnormalities in the development of the embryon produce all degrees of deviation from the typical human form. Excessive development may result in an extra finger or toe, or in the production of some peculiar excrescence. Deficiency of development may produce all degrees of abnormality from the simple harelip to the most frightful deficiency, as the absence of a limb, or even of a head. It is in this manner that those unfortunate individuals known as her¬ maphrodites are formed. An excessive development of some parts of the female generative organs gives them a great degree of similarity to the external organs of the male. A deficient development of the mas¬ culine organs renders them similar in appearance to those of the female. Excessive development shown in a peculiar manner produces both kinds of organs in the same individual in a state more or less complete. The uncouth shapes which are sometimes supposed to be the result of amalgamation with lower animals are produced in essentially the same manner. The stories which are frequently told of women giving birth to puppies and other animals have no foundation other than that mentioned. Such curious cases as the Carolina twins and Chang and Eng were formerly supposed to be the result of the union of two separate individr uals. It is now believed that they are developed from a single ovum. 240 ANATOMY , PHYSIOLOGY, AND HYGIENE. Hybrids. — It is a well-known law of biology that no progeny re¬ sult from union of animals of different species. Different 's arieties of the same species may in some cases form a fertile union, the result of which is a cross between its two parents, possessing some of the qual¬ ities of each. The mule is the product of such a union between the horse and the ass. A curious fact is that the offspring of such unions are themselves sterile almost without exception. The reason of this is that they do not produce mature elements of generation. In the mule, the zoosperms are either entirely absent or else very imperfectly devel¬ oped ; hence the fact that a colt having a mule for its sire is one of the rarest of curiosities, though a few instances have been reported. This is a wise law of nature to preserve the purity of species. Law of Sex. — If there is a law by which the sex of the developing embryon is determined, it probably has not yet been discovered. The influence of the will, the predominant vitality of one or the other of the parents, and the period at which conception occurs, have all been supposed to be the determining cause. A German physician some time since advanced the theory that the two testicles and ovaries produce elements of different sexual character, the right testicle forming zoo¬ sperms capable of producing only males, and the right ovary producing ova with the same peculiarity. The left testis and the left ovary he supposed to form the female elements. He claimed to have proved his theory by experiments upon animals. Even if true, this theory will not be made of practical importance. It is, in fact, nothing more than a revival of an old theory held by physicians who flourished more than two thousand years ago. More recently, another German physician has advanced the theory that the sex may be controlled at will by observing the time of fecunda¬ tion. He asserts that when fecundation occurs shortly after menstru¬ ation, the result will be a female ; but if impregnation occurs later in the month, and prior to the three or four days preceding the next men¬ strual period, a male will almost certainly be produced. This theory was proposed by Prof. Thury of the academy of Geneva, who claims to have thoroughly tested it in a great variety of ways, and always with an affirmative result. Dr. Heitzman, of New York, an instructor in pathological histology, and an eminent physiologist, informs us that he has thoroughly tested this theory, and finds it to be entirely reliable. There are numerous facts which seem to corroborate the truth of this theory, and future investigations may give to it the dignity of an estab¬ lished physiological fact. HEREDITY. 341 Heredity. — The phenomena of heredity are among the most inter¬ esting of biological studies. It is a matter of common observation that a child looks like its parents. It even happens that a child resembles an uncle or a grandparent more nearly than either parent. The same peculiarities are often seen in animals. The cause of this resemblance of offspring to parents and ancestors has been made a subject of careful study by Scientific men. We shall present the most recent theory adopted, which, although it be but a theory, presents such an array of facts in its support, and explains the phenomena in question so admirably, that it must be regarded as some¬ thing more than a plausible hypothesis. It is the conception of one of the most distinguished scientists of the age. The theory is known as the doctrine of pangenesis, and is essentially as follows : — It is a fact well known to physiologists that every part of the liv¬ ing body is made up of cellular elements which have the power to reproduce themselves in the individual, thus repairing the damage re¬ sulting from waste and injury. Each cell produces cells like itself. It is further known that there are found in the body numerous cen¬ tral points of growth. In every group of cells is found a central cell from which the others originated, and which determines the form of their growth. Every minute structure possesses such a center. A simple proof of this fact is found in the experiment in which the spur of a cock was grafted upon the ear of an ox. It lived in this novel situation eight years, attaining the length of nine inches, and nearly a pound in weight. A tooth has been made to grow upon the comb of a cock in a similar manner. The tail of a pig survived the oper¬ ation of transplanting from its proper position to the back of the an¬ imal, and retained its sensibility. Numerous similar illustrations might be given. The doctrine of pangenesis supposes that these centers of nutrition form and throw off not only cells like themselves, but very minute gran¬ ules, called gemmules, each of which is capable, under suitable circum¬ stances, of developing into a cell like its parent. These minute granules are scattered through the system in great numbers. The essential organs of generation, the testicles in the male and the ovaries in the female, perform the task of collecting these gem- mules and forming them into sets, each of which constitutes a repro¬ ductive element, and contains, in rudimentary form, a representative of every* part of the individual, including the most minute peculiarities. 342 ANATOMY, PHYSIOLOGY, AND HYGIENE. Even more than this : It is supposed that each ovum and each zoosperm contains not only the gemmules necessary to reproduce the individuals who produced them, but also a number of gemmules which have been transmitted from the individuals’ ancestors. If this theory be true, — and we can see no sound objection to it, — it is easy to understand all the problems of heredity. The gemmules must be very small indeed, but it may be suggested that the molecules of matter are smaller still, so this fact is no objection to the theory. It will be seen, then, that each spermatozoon, or zoosperm, actually contains, in an embryonic condition, every organ and tissue of the indi¬ vidual producing it. The same is true of the ovum. In other words, the reproductive elements are complete representatives, in miniature, of the parents, and contain all the elements for producing an offspring pos¬ sessing the same peculiarities as the parents. Various modifying circum¬ stances sufficiently explain the dissimilarities between parents and chil¬ dren. This theory is strikingly confirmed by the fact, previously mentioned, that in certain cases the ovum alone, a single reproductive element, may undergo a degree of development approaching very near to completion. It is supposed that fecundation is chiefly necessary to give to the gem¬ mules the requisite amount of nourishment to insure development. As we shall see hereafter, this matter has a very important bearing upon several practical questions. Ante-Natal Influences. — There can be no manner of doubt that many circumstances which it is entirely within the power of the parents to supply, exert a powerful influence in molding both the mental and the physical characteristics of offspring. By carefully availing himself of the controlling power given him by a knowledge of this fact, the stock-raiser is enabled to produce almost any required quality in his young animals. Pigeon fanciers show wonderful skill in thus produ¬ cing most curious modifications in birds. The laws of heredity and de¬ velopment are carefully studied and applied in the production of supe¬ rior horses, cows, dogs, and pigeons; but an application of the same principles to the improvement of the human race is rarely thought of. Human beings are generated in as haphazard and reckless a manner as weeds are sown by the wind. No account is taken of the possible influ¬ ence which may be exerted upon the future destiny of the new being by the physical or mental condition of parents at the moment when the germ of life is planted, or by the mental and physical conditions and A NTE-NA TA L IX FL UENGES. 343 surroundings of the mother while the young life is developing. Indeed, the assertion of a modern writer that the poor of our great cities virtu¬ ally “ spawn children,” with as little thought of influences and conse¬ quences as the fish that sow their eggs broadcast upon the waders, is not so great an exaggeration as it might at first sight appear to be. Men and women are constantly prone to forget that the domain of law is universal. Nothing comes by chance. The revolutions of the planets, studied by the aid of the telescope, and the gyrations of the at¬ oms, seen only by the eye of science, are alike examples of the controlling influence of law. Notwithstanding this sad ignorance and disregard of this vitally important subject, the effects of law are only too clearly manifested in the crowds of wretched human beings with which the world is thronged. An old writer sagely remarks, “ It is the greatest part of our felicity to be well born; ” nevertheless, it is the sad misfor¬ tune of by far the greater portion of humanity to be deprived of this inestimable “ felicity.” It is an established physiological fact that the character of offspring is influenced by the mental as well as the physical conditions of the parents at the moment of the performance of the generative act. In view of this fact, how many parents can regard the precocious — or even mature — manifestations of sexual depravity in their children without painful smitings of conscience at seeing the legitimate results of their own sensuality ? By debasing the reproductive function to an act of selfish animal indulgence, they imprinted upon their children an almost irresistible tendency to vice. Viewing the matter from this stand-point, what wonder that licentiousness is rife ! that true chastity is among the rarest of virtues ! Prof. O. W. Holmes remarks on this subject: “ There are people who think that everything may be done if the doctor, be he educator or phy¬ sician, be only called in season. No doubt ; but in season would often be a hundred or two years before the child was born, and people never send so early as that.” “Each of us is only the footing up of a double column of figures that goes back to the first pair. Every unit tells, and some of them ar a plus and some minus. If the columns don’t add up right, it is commonly because we can’t make out all of the figures.” It cannot be doubted that the throngs of deaf, blind, crippled, idiotic unfortunates who were “ born so,” together with a still larger class of dwarfed, diseased, and constitutionally weak individuals, are the lament¬ able results of the violation of some sexual law on the part of their pro¬ genitors. 344 ANATOMY, PHYSIOLOGY, AND HYGIENE. If parents would stop a moment to consider the momentous responsi¬ bilities involved in the act of bringing into existence a human being; if they would reflect that the qualities imparted to the new being will af¬ fect its character to all eternity ; if they would recall the fact that they are about to produce a mirror in which will be reflected their own char¬ acters divested of all the flimsy fabrics which deceive their fellow-men, revealing even the secret imaginings of their hearts, — there would surely be far less of sin, disease, and misery born into the world than at the present day; but we dare not hope for such a reform. To effect it, would require such a revolution in the customs of society, such a radical reform in the habits and characters of individuals, as nothing short of a temporal millennium would be able to effect. SEXUAL HYGIENE, Under this head we will consider some of the more general subjects relating to the health of the reproductive organism which have not been considered in connection with the special organs and functions described. The use of the reproductive function is perhaps the highest physical act of which man is capable, its abuse is certainly one of the most grievous outrages against nature which it is possible for him to perpe¬ trate. No observing person can doubt that the sexual relations of men and women determine in a great degree their happiness or misery in life. This subject, then, deserves due attention and careful consideration. It is of no use to scout it; for it will inevitably obtrude itself upon us, no matter how sedulously we attempt to avoid it. It can be rightly con¬ sidered only with the most perfect candor, with the mind unbiased by passion, and prayerfully anxious to know and do what is right. In the following paragraphs of this section are considered some of the evils out of which grows much of the sexual suffering of men and women : — Sexual Precocity. — There are two periods in human life when the sexual instincts should be totally dormant; and they are so when nature is not perverted. The first is the period reaching from infancy to pu¬ berty. The second is the period reached in advanced age. If raised strictly in accordance with natural law, children would have no sexual notions or feelings before the occurrence of puberty. No prurient speculation about sexual matters would enter their heads. Until that period, the reproductive system should lie dormant in its SEXUAL PRECOCITY. 345 undeveloped state. No other feeling should be exhibited between the sexes than that brotherly and sisterly affection which is so admirable and becoming'. © Fortunate, indeed, would it be for humanity if this natural state always existed; but it is a lamentable fact that it is rarely seen in modern homes. Not infrequently, evidences of sexual passion are manifested before the child has hardly learned to walk. It has been suggested that this precocity is nothing remarkable or unnatural, since it is often seen in little lambs and other young animals. To this it is only necessary to reply that the development of the sexual in¬ stincts perfectly corresponds with the longevity of the animal; if short-lived, like the sheep, only a short period intervenes between birth and the attainment of the sexual appetite and virility. If the animal is intended for long life, as is the case with man, these mani¬ festations are delayed, or should be, until a much later period. Dr. Acton, a distinguished English surgeon, makes the following excellent remarks upon this subject : — “ Slight signs are sufficient to indicate when a boy has this un¬ fortunate tendency. He shows marked preferences. You will see him single out one girl, and evidently derive an unusual pleasure (for a boy) in her society. His penchant does not take the ordinary form of a boy’s good nature, but little attentions that are generally reserved for a later period prove that his feeling is different, and sadly prema¬ ture. He may be apparently healthy, and fond of playing with other boys; still there are slight, but ominous, indications of propensities fraught with danger to himself. His play with the girl is different from his play with his brothers. His kindness to her is a little too ardent. He follows her, he does not know why. He fondles her with a tenderness painfully suggestive of a vague dawning of passion. No one can find fault with him. He does nothing wrong. Parents and friends are delighted at his gentleness and politeness, and not a little amused at the early flirtation. If they were wise, they would rather feel profound anxiety; and he would be an unfaithful or un¬ wise medical friend who did not, if an opportunity occurred, warn them that such a boy, unsuspicious and innocent as he is, ought to be carefully watched and removed from every influence calculated to foster his abnormal propensities.” We have been not more disgusted than shocked to see parents, whose intelligence ought to teach them better, not only winking at. S46 ANATOMY, PHYSIOLOGY, AND HYGIENE. but actually encouraging, these premature manifestations of passion in their children. They may yet learn, by bitter experience, the folly of their course, unless they make the discovery in time to avert, by careful reformatory training, the calamitous results which threaten the future of their children. Chastity. — In Ex. 20:14 and Matt. 5 : 28 we have a complete defi¬ nition of chastity. The seventh commandment, with the Saviour’s commentary upon it, places clearly before us the fact that chastity re¬ quires purity of thought as well as of outward acts. Impure thoughts and unchaste acts are alike violations of the seventh commandment. As we shall see, also, unchastity of the mind is a violation of natural law as well as of moral law, and is visited with physical punishment commensurate to the transgression. Mental Unchastity. — It is vain for a man to suppose himself chaste who allows his imagination to run riot amid scenes of amorous associations. The man whose lips delight in tales of licentiousness, whose eyes feast upon obscene pictures, who is ever ready to pervert the meaning of a harmless word or act into uncleanness, who finds de¬ light in reading vivid portrayals of acts of lewdness, — such a one is not a virtuous man. Man may not see these mental adulteries, he may not perceive these filthy imaginings; but One sees and notes them. They leave their hideous scars upon the soul. They soil and mar the mind ; and as the record of each day of life is photographed upon the books in Heaven, they each appear in bold relief, in all their innate hideousness. Foul thoughts once allowed to enter the mind, stick like the lep¬ rosy. They corrode, contaminate, and infect like the pestilence ; naught but Almighty power can deliver from the bondage of concu¬ piscence a soul once infected by this foul blight, this moral contagium. It is a wide-spread and deadly error, that only outward acts are harmful ; that only physical transgression of the laws of chastity will produce disease. We have seen all the effects of beastly abuse result from mental sin alone. “ I have traced serious affections and very great suffering to this cause. The cases may occur at any period of life. We meet with them frequently among such as are usually called, or think them¬ selves, continent young men. There are large classes of persons who seem to think that they may, without moral guilt, excite their own feelings or those of others by loose or libidinous conversation in soci- EARLY CAUSES. 347 ety, provided such impure thoughts or acts are not followed by mas¬ turbation or fornication. I have almost daily to tell such persons that physically, and in a sanitary point of view, they are ruining their constitutions. There are young men who almost pass their lives in making carnal acquaintances in the street, but just stop short of seducing girls ; there are others who haunt the lower classes of places of public amusement for the purpose of sexual excitement, and live, in fact, a thoroughly immoral life in all respects except actually going home with prostitutes. When these men come to me, laboring under the various forms of impotence, they are surprised at my suggesting to them the possibility of the impairment of their powers being de¬ pendent upon these previous vicious habits.”* “ Those lascivious day-dreams and amorous reveries, in which young people — and especially the idle and the voluptuous, and the sedentary and the nervous — are exceedingly apt to indulge, are often the sources of general debility, effeminacy, disordered functions, pre¬ mature disease and even premature death, without the actual exercise of the genital organs ; Indeed, this unchastity of thought — this adultery of the mind — is the beginning of immeasurable evil to the human family.” *f* “ Filthy dreamers,” before they are aware, become filthy in action. The thoughts mold the brain, as certainly as the brain molds the thoughts. Rapidly down the current of sensuality is swept the indi¬ vidual who yields his imagination to the contemplation of lascivious themes. Before he knows his danger, he finds himself deep in the mire of concupiscence. He may preserve a fair exterior ; but decep¬ tion cannot cleanse the slime from his putrid soul. How many a church member carries under a garb of piety a soul filled with abom¬ inations, no human scrutiny can tell. How many pulpits are filled by “ whited sepulchers,” only the Judgment will disclose. Early Causes. — The earliest of all causes is hereditary predispo¬ sition. As we have shown, a child conceived in lust can no more be chaste by nature than a negro can be a Caucasian. But back of this there is a deeper cause, as we shall see, one that affects parents as well as offspring. Between infancy and puberty, are in operation all those influences mentioned under “ Sexual Precocity.” The frequent custom of allowing children of opposite sex to * Acton. t Graham. 348 ANATOMY, PHYSIOLOGY, AND HYGIENE. sleep together, even until eight or ten years of age, or longer, is a dangerous one. We have known of instances in which little boys of seven or eight have been allowed to sleep with girls of fourteen or sixteen, in some of which most shameful lessons were taught, and by persons who would not be suspected of such an impropriety. In one instance a little boy of eight, occupying the same bed with three girls several years older, was used for illustration by the older girl in in¬ structing the younger ones in the 'modus operandi of reproduction. The sexes should be carefully separated from each other at least as early as four or five years of age, under all circumstances which could afford opportunity for observing the physical differences of the sexes, or in any way serve to excite those passions which at this tender age should be wholly dormant. Diet vs. Chastity . — From earliest infancy to impotent old age, under the perverting influence of civilization, there is a constant an¬ tagonism between diet and purity. When old enough to take food in the ordinary way, the infant’s tender organs of digestion are plied with highly seasoned viands, stimulating sauces, animal food, sweet¬ meats, and dainty tidbits in endless variety. Soon, tea and coffee are added to the list. Salt, pepper, ginger, mustard, condiments of every sort, deteriorate his daily food. If, perchance, he does not die at once of indigestion, or with his weakened forces fall a speedy victim to the diseases incident to infancy, he has his digestive organs impaired for life at the very outset of his existence. Exciting stimulants and condiments weaken and irritate his nerves and derange the circulation. Thus, indirectly, they affect the sexual system, which suffers through sympathy with the other organs. But a more direct injury is done. Flesh, condiments, eggs, tea, coffee, chocolate, and all other stimulants, have a powerful influence directly upon the reproductive organs. They increase the local supply of blood; and through nervous sympathy with the brain, the passions are aroused. Overeating, eating between meals, hasty eating, eating indigestible articles of food, late suppers, react upon the sexual organs with the utmost certainty. Any disturbance of the digestive function deteri¬ orates the quality of the blood. Poor blood, filled with crude, poorly digested food, is irritating to the nervous system, and especially to those extremely delicate nerves which govern the reproductive func¬ tion. Irritation provokes congestion ; congestion excites sexual de- BAD BOOKS. 349 sires ; excited passions increase the local disturbance ; and thus each reacts upon the other, ever increasing the injury and the liability to future damage. Thus, these exciting causes continue their insidious work through youth and more mature years. Right under the eyes of fathers and mothers they work the ruin of their children, exciting such storms of passion as are absolutely uncontrollable. Tobacco and Tice. — Few are aware of the influence upon morals exerted by that filthy habit, tobacco-using. When acquired early, it excites the undeveloped organs, arouses the passions, and in a few years converts the once chaste and pure youth into a veritable vol¬ cano of lust, belching out from its inner fires of passion torrents of obscenity and the sulphurous fumes of lasciviousness. If long-con¬ tinued, the final effect of tobacco is emasculation ; but this is only the necessary consequence of previous super-excitation. We are aware that we have made a grave charge against tobacco, and we have not hesitated to state the naked truth ; yet we do not think we have exaggerated, in the least, the pernicious influence of this foul drug. As much might be said against the use of liquor on the same grounds. Bad Books. — Another potent enemy of virtue is the obscene litera¬ ture which has flooded the land for many years. Circulated by secret agencies, these books have found their way into the most secluded dis¬ tricts. Every large school contains one or more of these emissaries of evil men and their Satanic master. Largely through the influence of Mr. Anthony Comstock, laws have been enacted which promise to do much toward checking this extensive evil, or at least causing it to make itself less prominent. Our news¬ papers still abound with advertisements of various so-called medical works, “ Marriage Guides,” etc., which are fruits of the same “ upas- tree” that Mr. Comstock has labored so faithfully to uproot. It is a painful fact, however, that the total annihilation of every foul book which the law can reach will not effect the cure of this evil, for our modern literature is full of the same virus. It is necessarily presented in less grossly revolting forms, half concealed by beautiful imagery, or embellished by wit ; but yet, there it is, and no law can reach it. The works of our standard authors in literature abound in lubricity. Pop¬ ular novels have doubtless done more to arouse a prurient curiosity in the young, and to excite and foster passion and immorality, than even 350 ANATOMY, PHYSIOLOGY , AND HYGIENE. the obscene literature for the suppression of which such active measures have recently been taken. The more exquisitely painted the scenes of vice, the more dangerously enticing. Novel-reading has led thousands to lives of dissoluteness. Many other causes might be enumerated, as idleness, evil associa¬ tions, etc., but we need not dwell longer on this point. Untliought-of Excesses. — Sexual wrong exists among the mar¬ ried as well as the unmarried, and that within the pale of the mar¬ riage rite. Ignorant or regardless of the consequences, many married people give loose rein to their passions, supposing that the marriage vow removes all duty of restraint. Nature does not, however, forget to inflict upon the offenders commensurate punishment for their wrong-doing. A long list of diseases, affecting both males and fe¬ males, might be presented as the direct consequences of this form of sexual transgression. Married people should recollect that the duty of restraint is as binding upon them after as before marriage. Without stopping to consider the various circumstances under which absolute continence is expedient, or desirable, or morally re¬ quired, we will pi-oceed at once to examine the question, Is continence harmful ? Continence not Injurious. — It has been claimed by many, even by physicians, — and with considerable show of reason, — that absolute continence, after full development of the organs of reproduction, could not be maintained without great detriment to health. It is needless to enumerate all the different arguments employed to support this po¬ sition, since they are, with a few exceptions, too frivolous to deserve attention. We shall content ourselves chiefly with quotations from acknowledged authorities, by which we shall show that the popular notions upon this subject are wholly erroneous. Their general ac¬ ceptance has been due, without doubt, to the strong natural bias in their favor. It is an easy matter to believe what agrees w'ell with one’s predilections. A bare surmise on the side of prejudice, is more telling than the most powerful logic on the other side. “ We know that this opinion is held by men of the world, and that many physicians share it. This belief appears to us to be erro¬ neous, without foundation, and easily refuted.”* The same writer claims “ that no peculiar disease nor any abridg- * Mayer. DOES NOT PRODUCE IMPOTENCE. 351 ment of the duration of life can be ascribed to such continence.” He proves his position by appealing to statistics, and shows the fallacy of arguments in support of the contrary view. He further says : — “ It is determined, in our opinion, that the commerce of the sexes has no necessities that cannot be restrained without peril.” “ A part has been assigned to spermatic plethora in the etiology of various mental affections. Among others, priapism has been attributed to it. In our opinion, this malady originates in a disturbance of the cerebral nerve power ; but it is due much less to the retention of sperm than to its exaggerated loss ; much less to virtuous abstinence than to moral depravity.” There has evidently been a wide-spread deception upon this subject. “ Health does not absolutely require that there should ever be an emis¬ sion of semen, from puberty to death, though the individual live a hun¬ dred years ; and the frequency of involuntary nocturnal emissions is an indubitable proof that the parts, at least, are suffering under a debility and morbid irritability utterly incompatible with the general welfare of the system.” Does not Produce Impotence. — It has been declared that strict continency would result in impotency. The falsity of this argument is clearly shown by the following observations : — “ There exists no greater error than this, nor one more opposed to physiological truth. In the first place, I may state that I have, after many years’ experience, never seen a single instance of atrophy of the generative organs from this cause. I have, it is true, met the complaint, but in what class of cases does it occur ? It arises, in all instances, from the exactly opposite cause, abuse ; the organs become worn out, and hence arises atrophy. Physiologically considered, it is not a fact that the power of secreting semen is annihilated in well-formed adults lead¬ ing a healthy life and yet remaining continent. No continent man need be deterred by this apocryphal fear of atrophy of the testes, from living a chaste life. It is a device of the unchaste, — a lame excuse for their own incontinence, unfounded on any physiological law.” * The truth of this statement has been amply confirmed by experi¬ ments upon animals. The complaint is made by those whose lives have been far otherwise than continent, that abstinence occasions suffering, from which indul- * Acton. 352 ANATOMY, PHYSIOLOGY, AND HYGIENE gence gives relief. The same writer further says that when such a pa¬ tient consults a medical man, “he should be told — and the result would soon prove the correctness of the advice — that attention to diet, gym¬ nastic exercise, and self-control, will most effectually relieve the symptoms.” Difficulty of Continence . — Some there are who urge that self-de¬ nial is difficult ; that the natural promptings are imperious. From this they argue that it cannot but be right to gratify so strong a passion. “ The admitted fact that continence, even at the very beginning of man¬ hood, is frequently productive of distress, is often a struggle hard to be borne, — still harder to be completely victorious in, — is not to be at all re¬ garded as an argument that it is an evil.” * But if rigid continence is maintained from the first, the struggle with the passions will not be nearly so severe as after they have once been allowed to gain the ascendency. On this point, the following re¬ marks are very j ust : — “ At the outset, the sexual necessities are not so uncontrolled as is generally supposed, and they can be put down by the exercise of a little energetic will. There is, therefore, as it appears to us, as much injustice in accusing nature of disorders which are dependent upon the genital senses, badly directed, as there would be in attributing to it a sprain or a fracture accidentally produced.” j- Helps to Continence. — As already indicated, and as every individ¬ ual with strong passions knows, the warfare with passion is a serious one if one determines to lead a continent life. He needs the help of ev¬ ery aid that he can gain. Some of these may be named as follows : — • The Will. — A firm determination must be formed to lead a life of purity ; to quickly quench the first suggestions of impurity ; to harbor no unchaste desire ; to purge the mind of carnal thoughts ; in short, to cleave fast to mental continence. Each triumph over vicious thoughts will strengthen virtue ; each victory won will make the next the easier. So strong a habit of continence may be formed that this alone will be a bulwark against vice. Diet. — He who would keep in subjection his animal nature must carefully guard the portal to his stomach. The blood is made of what is eaten. Irritating food will produce irritating blood. Stimulating foods or drinks will surely produce a corresponding quality of blood. * Ibid. t Mayer. HELPS TO CONTINENCE. 353 Irritating, stimulating blood will irritate and stimulate the nervous sys¬ tem, and especially the delicate nerves of the reproductive system, as pre¬ viously explained. Only the most simple and wholesome food should be eaten, and that only in such moderate quantities as are required to re¬ plenish the tissues. The custom of making the food pungent and stim¬ ulating with condiments is the great, almost the sole, cause of gluttony. It is one of the greatest hindrances to virtue. Indeed, it may with truth be said that the devices of modern cookery are most powerful al¬ lies of unchastity and licentiousness. This subject is particularly deserv¬ ing of careful, candid, and studious attention, and only needs such in¬ vestigation to demonstrate its soundness. Exercise. — Next to diet as an aid to continence, perhaps of equal importance with it, is exercise, both physical and mental. It is a trite proverb, the truth of which every one acknowledges, that “ Satan finds some mischief still for idle hands to do,” and it is equally true that he always has an evil thought in readiness — speaking figuratively — to in¬ still into an unoccupied mind. A person who desires to be pure and continent in body and mind must flee idleness as he would the devil himself ; for the latter is always ready to improve upon the advantages afforded by an idle moment, an hour given to reverie. Walking, riding, rowing, and gymnastics are among the best modes of physical exercise for sedentary persons ; but there is no better form of exercise than working in the garden. The cultivation of small fruits, flowers, and other occupations of like character, really excel all other modes of physical exercise for one who can engage in them with real pleasure. Dozing is bad at any time ; for it is a condition in which the will is nearly dormant, though consciousness still lingers, and the imag¬ ination is allowed to run wild, and often enough it will run where it ought not. Late study, or late hours spent in any manner, is a sure means of producing general nervous irritability and sexual excitement through reflex influence. Bathing. — A daily bath with cool or tepid water, followed by vigor¬ ous rubbing of the skin with a coarse towel and then with the dry hand, is a most valuable aid. The hour of first rising is generally the most convenient time. General and local cleanliness are indispensable to gen¬ eral and local health. Religion. — After availing himself of all other aids to continence, if he wishes to maintain purity of mind as well as physical chastity, — and one cannot exist long without the other, — the individual must seek that 23 354 ANATOMY, PHYSIOLOGY, AND HYGIENE. most powerful and helpful of all aids, divine grace. If, in the conflict with his animal nature, man had only to contend with the degrading in¬ fluences of his own propensities, the battle would be a serious one, and it is doubtful whether human nature alone — at least in any but rare cases — would be able to gain the victory; but, in addition to his own* inherent tendencies to evil, man is assailed at every point by unseen agencies that seek to drag him down and spoil his soul with lust. These fiendish influences are only felt, not seen, from which some argue that they do not exist. Such casuists must find enormous depths for human depravity. But who has not felt the cruel power of these unseen foes ? Against them, there is but one safe, successful weapon, “ the blood of Christ which cleanse th from all sin.” The struggling soul, beset with evil thoughts, will find in prayer a salvation which all his force of will, and dieting and exercising, will not, alone, insure him. Yet prayer alone will not avail. Faith and works must always be associated. All that one can do to work out his own salvation, he must do; then he can safely trust in God to do the rest, even though the struggle seems almost a useless one ; for when the soul has been long in bondage to concupiscence, the mind a hold of foul and lustful thoughts, a panorama of unchaste imagery, these hateful phantoms will even intrude themselves upon the sanctity of prayer, and make their victim mentally unchaste upon his knees. But Christ can pity even such ; and even these degraded minds may yet be pure if with the psalmist they continue to cry, with a true purpose and unwavering- trust, “ Create in me a clean heart, O God, and renew a right spirit within me.” “ Purge me with hyssop, and I shall be clean ; wash me, and I shall be whiter than snow.” At the first suggestion of an evil thought, send up a mental prayer to Him whose ear is always open. Prayer and impurity are as incom¬ patible as oil and water. The pure thoughts that sincere prayer will bring, displace the evil promptings of excited passion. But the desire for aid must be sincere. Prayer will be of no avail while the mind is half consenting to the evil thought. The evil must be loathed, spurned, detested. It would seem almost unnecessary to suggest the impropriety of re¬ sorting to prayer alone when sexual excitability has arisen from a cul¬ pable neglect to remove the physical conditions of local excitement by the means already mentioned. Such physical causes must be well looked after, or every attempt to reform will be fruitless. God requires SEXUAL CRIMES. 355 of every individual to do for himself all that he is capable of doing; to employ every available means for alleviating his sufferings. Sexual Crimes. — The sexual crimes with which we wish to deal, as being those most seldom referred to, are prevention of conception, and intentional abortion. The first-mentioned, we are aware, is hardly considered a crime by the majority of people; and the same might be said respecting the second with large numbers of persons, though it is so recognized by the law. All medical authorities agree that prevention of conception, no matter by which one of the numerous methods commonly employed it may be induced, is always harmful and productive of disease. Personal experience in the medical carQ of a large number of ladies suffering with all forms of sexual derangements has enabled us to confirm this judgment many times. As it cannot be told at just what moment fecundation takes place, and as it may occur immediately, some of the methods employed for prevention plainly in¬ volve moral principles most seriously. It has been previously shown that in the ovum of the female, and the spermatozoon of the male, are, in rudimentary form, all the elements which go to make up the “ human form divine.” Alone, neither of these elements can become anything more than it already is ; but the instant that the two ele¬ ments come in contact fecundation takes place, and the individual life begins. From that moment until maturity is reached, years subse¬ quently, the whole process is only one of development. Nothing ab¬ solutely new is added at any subsequent moment. In view of these facts, it is evident that at the very instant of conception the embry¬ onic human being possesses all the right to life it ever can possess. It is just as much an individual, a distinct human being, possessed of soul and body, as it ever is, though in a very immature form. That conception may take place during the reproductive act cannot be denied. If, then, means are employed with a view to prevent conception im¬ mediately after the accomplishment of the act, or at any subsequent time, if successful, it would be by destroying the delicate product of the conception which had already occurred, and which, as before observed, is as truly a distinct individual as it can ever become — certainly as in¬ dependent as at any time previous to birth. Is it immoral to take human life ? Is it a sin to kill a child ? Is it a crime to strangle an infant at birth ? Is it a murderous act to de¬ stroy a half-formed human being in its mother’s womb ? Who will dare to answer “ No,” to one of these questions ? Then, who can re- 35 G ANATOMY, PHYSIOLOGY, AND HYGIENE. fuse assent to the plain truth that it is equally a murder to deprive of life the most recent product of the generative act ? Who can number the myriads of murders that have been perpe¬ trated at this early period of existence ? Who can estimate the load of guilt that weighs upon some human souls ? and who knows how many brilliant light? have been thus early extinguished ? how many promising human plantlets thus ruthlessly destroyed in the very act of germinating ? It is to be hoped that in the final account the ex¬ tenuating influence of ignorance may weigh heavily in the scale of justice against the damning testimony of these “ unconsidered murders.” Criminal Abortion* — Few but medical men are aware of the enormous proportions which have been assumed by this terrible crime during the present century. That it is increasing with fearful rapid¬ ity and has really reached such a magnitude as to seriously affect the growth of civilized nations, and to threaten their very existence, has become a patent fact to observing physicians. An eminent medical author asserts “ that the frequency of this form of destroying human life exceeds all others by at least fifty per cent, and that not more than one in a thousand of the guilty parties receive any punishment by the hand of civil law. But there is a surer mode of punishment for the guilty mother in the self-executing laws of nature.” The destruction of the child after the mother has felt its move¬ ments is termed infanticide ; before that time it is commonly known as abortion. It is a modern notion that the child possesses no soul or individual life until the period of quickening, an error which we have already sufficiently exposed. The ancients, with just as much reason, contended that no distinct life was present until after birth. Hence it was that they could practice without scruple the crime of infanti¬ cide to prevent too great increase of population. The effects of this crime are not upon the child alone. The mother suffers not only imminent peril of life at the time, but the almost cer¬ tain penalty of chronic invalidism the remainder of her life. We have good authority for the assertion that abortion is fifteen times as dan¬ gerous as natural childbirth. With reference to the immorality of the act the eminent author of “ The Ten Laws of Health ” says : — “ There are those who would fain make light of this crime by at¬ tempting to convince themselves and others that a child, while in embryo, has only a sort of vegetative life, not yet endowed with CRIMINAL ABORTION. thought, and the ability to maintain an independent existence. If such a monstrous philosophy as this presents any justification for such an act, then the killing of a newly-born infant, or of an idiot, may be likewise justified. The destruction of the life of an unborn human being, for the reason that it is small, feeble, and innocently helpless, rather aggravates than palliates the crime. Every act of this kind, with its justification, is obviously akin to that savage philosophy which accounts it a matter of no moment, or rather a duty, to destroy feeble infants, or old, helpless fathers and mothers.” * “ From a very large verbal and written correspondence in this and other States, I am satisfied that we have become a nation of mur¬ derers” f Said a distinguished clergyman of Brooklyn in a sermon, “ Why send missionaries to India when child-murder is here of daily, almost hourly occurrence ; aye, when the hand that puts money into the con¬ tribution-box to-day, yesterday or a month ago, or to-morrow, will murder her own unborn offspring ? ” Whether this gigantic evil can ever be eradicated, is exceedingly doubtful. To effect its cure would be to make refined Christians out of brutal sensualists ; to emancipate woman from the enticing, allur¬ ing slavery of fashion ; to uproot false ideas of life and its duties, — in short, to revolutionize society. The crime is perpetrated in secret. Many times no one but the criminal herself is cognizant of the evil deed. Only occasionally do cases come near enough to the surface to be dimly discernible ; hence the evident inefficiency of any civil legis¬ lation. But the evil is a desperate one, and is increasing ; shall no attempt be made to check the tide of crime and save the sufferers from both physical and spiritual perdition ? An effort should be made, at least. Let every Christian raise the note of warning. From every Christian pulpit let the truth be spoken in terms too plain for misap¬ prehension. Let those who are known to be guilty of this most re¬ volting crime be looked upon as murderers, as they are ; and let their real moral status be distinctly shown. It should be known, too, that wives are not the only ones to be blamed in this matter. In many instances husbands are the insti¬ gator's as well as the abettors of the crime, and in their hands lies the power to stay the sacrifices to this horrible modern Mo¬ loch. *J. R. Black, M. D. t Reamy. 358 ANATOMY, PHYSIOLOGY, AND HYGIENE. Secret Tice. — We most deeply deplore the necessity for mention¬ ing one more evil akin to those already dwelt upon ; but our knowl¬ edge of the great prevalence and terrible consequences of the awful sin known as solitary or secret vice, masturbation, etc., presses upon us the obligation to let no fit opportunity pass without raising a wrarning voice. This pernicious habit, which is so common that we need not describe it, we are loth to say, but must in deference to truth, is by no means confined to boys ; girls also indulge in it, though, it is to be hoped, to a less fearful extent than boys, at least in this country. A Russian physician, quoted by an eminent medical professor in New York, stated in our hearing that the habit is uni¬ versal among girls in Russia. It seems impossible that such a state¬ ment should be true ; and yet we have not seen it contradicted. It is more than probable that the practice is far more nearly universal everywhere than even medical men are willing to admit. Many young men who have been addicted to the vice, have, in their confes¬ sions, declared that they found it universal in the schools in which they learned the practice. Parents who have no suspicion of the evil, who think their chil¬ dren the embodiment of purity, will find by careful observation and inquiry, — though personal testimony cannot be relied upon, — that in numerous instances their supposed virtuous children are old in cor¬ ruption. Such a revelation has brought dismay into many a family, only too late in some cases. Said a wealthy and intelligent lady in whose hands our work entitled “ Plain Facts for Old and Young” was placed by an agent, “ Oh, if I had only seen this work ten years ago my poor boy might have been saved ! ” She was the mother of a large family of sons and daughters, most of whom were remarkably bright and intelligent. But one had fallen a victim to this awful vice, and was then in an insane asylum, his mind a hopeless wreck, in conse¬ quence. The causes of this vice are numerous, including all which tend to 7 O produce sexual precocity, and those which have been enumerated as leading to unchastity. These we need not recapitulate ; we would, however, mention one cause which in our opinion is, more than all others, the exciting agent in the propagation of the vice ; viz., — Evil Associations. — The influence of evil companionship is one of the most powerful agents for evil against which those who love purity and are seeking to elevate and benefit their fellow-men have SECRET VICE. 339 to contend. A bad boy can do more harm in a community than can be counteracted by all the clergymen, Sabbath-school teachers, tract- distributers, and other Christian workers combined. An evil boy is a pest, compared with which the cholera, small-pox, and even the plague, are nothing. The damage which would be done by a terrific hurricane sweeping with destructive force through a thickly settled district is insignificant compared with the evil work which may be accomplished by one vicious lad. No community is free from these vipers, these agents of the arch¬ fiend. Every school, no matter how select it may be, contains a greater or less number of these young moral lepers. Often they pur¬ sue their work unsuspected by the good and pure, who do not dream of the vileness pent up in the young brains which have not yet learned the multiplication table, and scarcely learned to read. We have known instances in which a boy of seven or eight years of age has implanted the venom of vice in the hearts and minds of half a score of pure-minded lads within a few days of his first association with them. This vice spreads like wild-fire. It is more “ catching ” than the most contagious disease, and more tenacious, when once im¬ planted, than the leprosy. Boys are easily influenced either for right or for wrong, but espe¬ cially for the wrong; hence it is the duty of parents to select good companions for their children, and it is the duty of children to avoid bad company as they would avoid carrion or the most loathsome ob¬ ject. A boy with a match-box in a powder-magazine would be in no greater danger than in the company of most of the lads who attend our public schools and play upon the streets. It is astonishing how early children, especially boys, will sometimes learn the hideous, shameless tricks of vice which yearly lead thousands down to ever¬ lasting death. Often children begin their course of sin while yet cradled in their mother’s arms, thus early taught by some vile nurse. It were better for a boy never to see or associate with a lad of his own age than to run any risk of being corrupted before he is old enough to appreciate the terrible enormity of sin and the awful con¬ sequences of transgression. It should be recollected also that not only young boys but vicious youths and young men are frequently the in¬ structors in vice. It is unsafe to trust any but those who are known to be pure. But the difficulties of knowing who is to be trusted are so great that the only real safety is in beginning at a very early age SCO ANATOMY, PHYSIOLOGY, AND HYGIENE. to fortify the minds of the little ones against the danger by admoni¬ tions and instruction suited to their age and understanding. The Evil Underestimated. — While there have been those who have exaggerated the consequences of secret vice for nefarious purposes there is another class of physicians who take the opposite extreme, declaring that its effects are slight, and often not felt at all. We are at something of a loss to decide which class lias done the most harm, the quacks who have basely excited fears beyond what the facts would warrant, for their own selfish advantage, or the medical gentlemen — most of them quite eminent in the profession — who, by declaring the vice to be harmless, have encouraged its propagation. We have no part with either class. The consequences which we have seen in our own experience, having had scores of the victims under our professional care, are sufficiently ter¬ rible to warrant us in raising a warning cry which we would gladly make loud enough to reach the ears of every child and youth in Amer¬ ica. The vice is an exterminating one. It ruins more lives than all other sexual vices together, because the most prevalent. We have not space here to dwell at length upon its symptoms and treatment, and need not do so, as we have discussed the subject at length elsewhere. FOOD AND DIET. A\ e need not dwell upon the importance of this department of hygiene, as there can be no doubt that this subject is one of the most important of all which relate to the physical welfare of human beings. Since the human body is made of what is received into it in the form of food, it is evident that the character of a person’s food will determine his own character. Experiments have again and again proved this to be true of animals, and it can be no less true of human beings. A few facts bearing on this point may not be without interest to the general reader. It has been found that the bones of hogs fed on food which had been colored with madder, a peculiar coloring matter, were stained the same color. When herbivorous animals are fed on animal food their flesh ac¬ quires an unpleasant and unpalatable flavor. M. Monclar, a French agriculturist, has been experimenting upon this subject, and finds that he can flavor the flesh of animals at pleasure by feeding them upon various kinds of food and employing a variety of strong flavoring substances. He was led to investigate the subject by the observation that hares killed in a wormwood field, and eggs laid by hens which had eaten diseased silk- worms, had such a nauseous taste that no one could eat them. These facts accord well with an account which we published some years ago of the poisoning of a family by eating- chickens which had fed upon potato bugs. A few years ago, also, a case was reported in which a family in Ohio were poisoned, some per¬ sons fatally, by eating chickens which had feasted upon the carcass of a cow that died of milk sickness. Hr. Parkes, the eminent English writer on hygiene, mentions the fact that a regiment of soldiers under his care were attacked by diarrhea in consequence of eating pork which had been fed on garbage. Plenty of instances might be cited to show that thousands of infants have lost their lives in consequence of eating the milk of cows fed on swill or distillery slops. 361 362 FOOD AND DIET. Numerous other evidences might be given on this point, but these are sufficient. Definition of Food. — The numerous definitions of food which have been framed at different times and by different persons, too often, we have reason to fear, have been made to fit some pet hobby or pre¬ conceived notion. We offer the following as being the most nearly in accordance with what is known of the relation of various substances called foods to the human system : Foods are those substances which when introduced into the system are capable of supplying the loss oc¬ casioned by the natural wastes of the body. When considered in its broadest sense, the term food includes all liquids and gases as well as solids capable of supplying the needs of the body resulting from the wear and tear of the system. We shall consider under this head, however, only solids and liquids, or what are usually termed food and drink. Classification of Foods. — For our purpose, food may be simply classified as follows : — 1. Albuminous, or nitrogenous. 2. Farinaceous and saccharine. 3. Oleaginous, or fatty. 4. Inorganic. Albuminous Elements. — An example of nearly pure albumen is found in the white of egg. This may be considered as a type of the whole class of albuminous or nitrogenous food elements, a great va¬ riety of which are found in both the animal and the vegetable king¬ dom. In wheat, this class is represented by gluten ; in oatmeal, by vegetable albumen ; in peas, beans, and other leguminous seeds, by vegetable caseine. In animal foods we have the albumen of eggs, al¬ bumen and fibrine of the blood, and more or less in most animal tis¬ sues ; the caseine of milk ; etc. All elements of this class sustain es¬ sentially the same relation to the system and to the organs of digestion, so that no discrimination need be made between them here. As a class, when digested and formed into blood, they serve to nourish the living or most highly vitalized tissues of the body, as the muscles, brain, nerves, glands, and other active organs. Associated with the albuminous elements are the various salts which nourish the bones and also enter into the composition of a few of the other tissues. The experiments of Dr. Austin Flint upon the pedestrian Weston, as well as the experiments of Prof. Liebig, Subbotin, and many other STARCH AND SUGAR. 303 distinguished physiologists, show very clearly that the nitrogenous elements are the chief supporters of vital activity, muscular and nerv¬ ous effort, etc., and that food can only support vital action or give rise to force by being assimilated into living tissue. Starch and Sugar, — The farinaceous and saccharine class includes all varieties of starch and sugar. All vegetables and grains, and most fruits, contain starch. In some cases, as in most grains and in such vegetables as potatoes, turnips, and most other fleshy roots and tubers, starch is the most abundant element, often constituting as large a pro¬ portion as two-thirds or three-fourths of the whole bulk or weight of the article of food. Each particular vegetable, grain, or fruit has its own peculiar variety of starch ; but the difference is chiefly in the form and size of the separate par¬ ticles or granules. The only ex¬ ception to this statement is that the starch of vegetables is, in gen¬ eral, less easy of digestion than that of grains. In its raw state, each little par¬ ticle or granule of starch (Fig. 140) is inclosed in an envelope, which protects it from the action of water, rendering it insoluble. By the process of cooking, and in fruits by the ripening process, this envelope is dissolved or ruptured, and the homogeneous contents of the granules are thus rendered soluble, a change which is necessary before digestion can take place. There are several varieties of sugar, which differ among themselves much more than do the several varieties of starch. The most common variety is cane-sugar, which is chiefly manufactured from the different varieties of sugar-cane, although it is also made from the juice of the sugar beet and from the sap of the maple-tree. It is found, also, in considerable quantities, in the date and in a few other fruits. Cane- sugar is the sweetest of all the sugars. Grape-sugar, or glucose , is the name of the variety of sugar which is most abundant in nature, being found in grapes and many other fruits. It is the most easily digestible of the various sugars, requiring, in fact, no digestion, being absorbed, without further change, aloug v\ ith the CD ' CD FOOD AND DIET. 304 glucose produced by digestion, since this is one of the products of the digestion of starch, as will be seen presently. The saccharine ingre¬ dient of milk is known as milk-sugar, or lactose. It is much less sweet than the other varieties of sugar, but possesses the same general properties. The close relation between starch and sugar is seen by the fact that in the plant one element is derived from the other. The starch of grains, of the potato, of nearly all seeds, in fact, is in the process of germination converted into sugar, when it becomes nourishment for the growing plant. The rapid growth of new leaves formed by the ma¬ ple and other trees in the spring is through the production of sugar from the starch stored up in the roots of the tree in the fall. In the spring, the vital processes of the plant convert this insoluble starch into soluble sugar, and by its ascent with the sap, the astonishingly rapid growth often noted in the spring is effected. By tapping the tree at this period, as is done in the case of the maple, a portion of the sap may be abstracted, and by its condensation, maple sugar is made. It is possible for the chemist to imitate nature in a limited degree in this sugar-making process, since, as is well known, starch may be converted into glucose, or grape-sugar, by purely chemical processes. It is even possible for the chemist to produce sugar out of woody fibre, as from paper, straw, cotton cloth, or sawdust, the struct¬ ures which are formed in the plant by the assimilation of starch or sugar. Being originally formed from sugar, the chemist is able to> bring it back to its original condition again, though not in a state in which it can be utilized as food by the human system. This close re¬ lation of starch and sugar places them in the same class, although they are treated somewhat differently by the organs of digestion, and can by no means be taken interchangeably as food for reasons which will appear when we have considered at length the mode of digestion of these two alimentary elements. The principal nutritive value of this class of foods, like that of the class of fatty elements, is to supply material for the support of ani¬ mal heat. Just how the changes necessary to the evolution of heat are effected, is not fully understood ; but it is well established that such changes do occur. Fats. — Little need be said on this subject, as every one is familiar with the various fats which usually enter into the composition of food. Butter, lard, and suet are the principal animal fats. Most of the INORGANIC ELEMENTS. 365 grains, some vegetables, a few fruits, and especially nuts, contain vari¬ ous vegetable oils ; but the elements of the different varieties of ani¬ mal and vegetable fats are essentially the same, the three fatty ele¬ ments, oleine, margarine, and stearine, differing chiefly in consistency at ordinary temperatures. The differences in the various fats and oils are principally due to the different proportions in which these various elements are combined. Fats are insoluble in water, but dissolve readily in alcohol, and in oils. In mucilaginous and alkaline fluids they are divided into very minute particles, forming what is termed an emulsion, in which form they exist in milk, which is an alkaline fluid. Being lighter than the 141. Milk Globules. other constituents of milk they naturally rise to the surface, forming the cream. By the process of churning, the separate particles are made to unite, thus producing butter. In Fig. 141 may be seen the appearance of healthy milk when viewed by a microscope of good magnifying powers. In animal tissues, fats are found in the form of cells, as shown in Fig. 142. Each cell has a wall of connective tissue which retains its contents until digested by the gastric juice. In vegetable produc¬ tions the fatty elements are closely associated with the albuminous and inorganic, a fact which furnishes an additional argument in favor of the use of oatmeal, and the unbolted meal of other grains. Like the farinaceous and saccharine elements of food, the fatty elements are chiefly useful for the support of animal heat, although a few other uses are assigned to them. It should be remarked in this connection that saccharine and farinaceous substances are included in what is called the carbonaceous class of food elements, this class being so named because the sub- 3GG FOOD AND DIET. stances included in it contain a large proportion of carbon and no ni¬ trogen, by which they are distinguished from albuminous elements. Inorganic Elements. — In addition to the three classes of ele¬ ments named above, the chemist finds, upon making a chemical analy¬ sis of foods, certain salts, the chief of which are phosphates and car¬ bonates of potash, soda, and lime, and chlorides of potash and soda. These elements cannot be extracted from foods by a simple mechan¬ ical process, as can starch, sugar, gluten, and the other elements- named, but are only found upon destruction of the food substance. The most careful microscopical examination of the various food sub¬ stances does not reveal the presence of any of these elements in an in¬ organic state. There is good reason for believing that they are in an organic or partly organized state as they exist in food substances. Similar investigations show that the so-called inorganic elements exist- in this state in the animal tissues, even in the bones, which contain the largest proportion of this kind of matter of any of the tissues. The principle was established long ago that animals cannot or¬ ganize or vitalize matter, but simply possess the power to appropriate nourishment in the form of substance which has been already vital¬ ized by the vegetable kingdom. In addition to the elements already mentioned under this head, all vegetable foods contain a certain proportion of innutritions matter which constitutes the framework of the tissue, being of a woody char¬ acter. Vegetable cells of all sorts contain more or less of this woody material, or cellulose, in their composition. Most animal foods also contain more or less indigestible elements. Although wholly indigestible in character, and so not directly nu¬ tritious, these elements of food are really very useful; first, in giving the required bulk to the food ; and, second, in producing the mechan¬ ical irritation necessary to excite proper secretion and muscular action to carry on the digestive process. Thus they become a very impor¬ tant accessory to digestion and nutrition. It is partly on this account that oatmeal, wheat meal, or graham flour, and other whole-grain products, are so much to be preferred above the superfine flour which millers take pride in producing of the utmost possible fineness and whiteness. Superfine flour is distinctly a modern invention. The ancients used unbolted meal altogether, the present disease-producing devices known as bolting machines being then not in use. Indeed, many nations at the STRUCTURE OF WHEAT. 367 present day, as the Germans, Scandinavians, and, in fact, most nations, with the exception of the French, English, and American nations, still adhere, substantially, to the ancient custom in this regard. No doubt the hardihood of the native German peasant is in great part justly at¬ tributable to the highly nourishing qualities of his “ black bread.” The “ New Process ” dour now manufactured is much superior to that of superfine character, as it contains a much larger proportion of the elements especially cal¬ culated to nourish the brain and nerves and to support the vigor and vitality of the body. It may be interesting in this connection to give a little attention to the structure of a kernel of grain, by studying the accompanying cuts, taking the wheat as a type of all the grains. Fig. 143 shows a grain of wheat greatly magnified, the rough, hairy character of the surface being made very apparent. In Fig. 144 is seen half of a grain which has been subjected to a process for removing the rough external covering of the grain. Fig-. 143. nified. Grain of Wheat mag Fig:. 144. Grain of Wheat with Husk removed. Fig-. 145. Transverse Section of Grain of Wheat. Fig. 146. Same as Fig. 143, more highly magnified. Fig. 145 is a magnified section of the central portion of a grain, showing; the internal cellular structure of the grain. o o Fig. 146 represents a small portion of a similar section more highly magnified, showing the various layers of the grain with great distinct- 368 FOOD AND DIET. Pig1. 147. Same as Fig. 145. Very highly magnified. Fig. i48. This eut shows the General Struct- ure of t ie Grain of Wheat. ness. a. Represents the outer, woody layer, or bran ; b. The layer just beneath, which con¬ tains more or less woody matter and is very rich in nitrogenous matter, the “ salts,” and, in some grains, with fatty matters; c. and d. Other cellular layers cov¬ ering the central portion of the grain, rich in albuminous ele¬ ments ; e. f. g. The central or starchy portion of the grain, which is the chief constituent of superfine flour. Fig. 147 show’s all of these layers much more greatly mag¬ nified. Fig. 148. This cut shows the several layers of cells 'which compose the grain of wheat. All but the outermost of these con¬ tain in abundance the most im¬ portant of all the vegetable food products. We are indebted for the use of these cuts to the court¬ esy of the Franklin Mills Co., of Lockport, N. Y., by whom they were made, to illustrate the ad¬ vantages of their flour made from the entire wheat by a process which retains all its nutritive properties in a form the most easy of digestion. Food Elements not Food. — By means of numerous experiments at the expense of numberless dogs, rabbits, pigeons, cats, and other animals, it has been clearly demonstrated that while the various ele¬ ments mentioned are food elements, they are not in themselves food, either when taken alone or "when artificially mixed. Dogs fed on al¬ bumen, fibrine, or gelatine, — the constituents of muscle, — died in about FOOD SUBSTANCES. 3G9 a month. The same result followed when they were fed on the con¬ stituents of muscle artificially mixed. A goose fed on the white of egg died in twenty-six days. A duck fed on butter starved to death in three weeks, with the butter exuding from every part of its body, its feathers being saturated with fat. Dogs fed on oil, gum, and sugar, died in four to five weeks. A goose fed on gum died in sixteen days ; one fed on sugar, in twenty-one days ; two that had only starch lived twenty-four and twenty-seven days. Dogs fed on white, fine-flour bread lived but fifty days. Dogs fed on brown military bread made of the whole grain were maintained in perfect health. Dogs fed on the so-called inorganic elements, the salts which are ex¬ tracted from flesh, died sooner than those which had nothing at all. Food Substances. — The various substances, used for food are classified, first, as animal and vegetable. The first class includes the flesh of animals of all kinds ; for every one of the various classes of the animal kingdom, from highest to lowest, has been drawn upon to contribute to the sustenance or to gratify the palate of human beings. Eltlts and milk are included in this class. The second class also includes a great variety of productions, all parts of plants of one species or another contributing to the food of man. Vegetable food is rather imperfectly classified into fruits, grains, ?/nd vegetables. This division is quite faulty, as neither of the classes properly includes nuts or such seeds as peas and beans. Vegetables include all other parts of plants used as food with the exception of the seed portions. Pumpkins, squashes, cucumbers, melons, and similar foods usually called vegetables, are really fruits. The following table shows the proportion of solid matter, chiefly nutriment, contained in one hundred parts of some of the more com¬ mon substances employed as food ; the table is arranged from Leth- eby’s and Smith’s works on food, and gives the results of the most recent examinations of the several articles named in the list. 24 370 FOOD AND DIET. Table of Nutritive Values of Various Articles of Food. ARTICLES. Water. Albumen, Etc. Starch. Sugar. Fat. Salts. Total Nutritive Elements. Bread . 37 8.1 47.4 3.6 1.6 2.3 63 Wheat Flour. . 15 10.8 66.3 4.2 2 1.7 85 Barley Meal. . . 15 6.3 69.4 4.9 2.4 2 83 Oatmeal . 15 12.6 58.4 5.4 5.6 3 85 Bye Meal . 15 8 69.5 3.7 2 1.8 85 Indian MtaL . . 14 11.1 64.7 0.4 8.1 1.7 85 Bice . 13 6.3 79.1 0.4 0.7 0.5 87 Peas . 15 23 55.4 2 2.1 2.5 85 Beans . 15 23 55.4 2 2.1 2.5 85 Lentils . • . .... 77 Arrowroot .... 18 .... 82 82 Potato . 75 2.1 18.8 3.2 0.2 0.7 25 Sweet-Potato . . 68 1.5 17.3 10 0.3 2.9 32 Carrot . 83 1.3 8.4 6.1 0.2 1 17 Beet . 83.5 1.5 0.8 10.5 3.7 16.5 Parsnip . 82 1.1 9.6 5.8 0.5 1 18 Cabbage . .... . . . . 5.6 Turnip . 91 1.2 5.1 2.1 0.6 9 Sugar . 5 .... 95 95 Treacle . 23 77 i ( New Milk . 86 4.1 5.2 3.9 0.8 14 Cream . 66 2.7 2.8 26.7 1.8 34 Skim-Milk .... 88 4 5.4 1.8 0.8 12 Buttermilk .... 88 4.1 6.4 0.7 0.8 12 Lean Beef . 72 19.3 3.6 5.1 28 Lean Mutton . . 72 18.3 4.9 4.8 28 Yeal . 63 16.5 15.8 4.7 37 Poultry . 74 21 3.8 1.2 26 White-Fish. . . . 78 18.1 2.9 1 22 Salmon . 77 16.1 5.5 1.4 23 Entire Egg . 74 14 10.5 1.5 26 W hite of Egg. . 78 20.4 1.6 22 Volk of Egg. .. 52 16 30.7 1.3 48 Bread-Fruit . . . 80 20 Banana . 73 27 Date . 33 9 58 .... 67 ACID. Grape . 79.8 1.7 1.1 13.8 0.5 0.5 17.6 Apple . 82 8 0.8 6.5 0.4 15.7 Pear . 85 4.6 • > • • 7.9 0.3 12.8 Peach . 85 0.5 0.6 1.6 0.4 3.1 Plum . 81 0.5 1 3 0.3 4.8 Mul berry . 84.7 0.4 1.8 9.2 0.7 12.1 Blackberry .... 86 0.5 1.2 4.4 0.4 6.5 Cherry . 80.5 2.7 1.3 8.7 0.6 13.3 Apricot . 82 0.4 0.7 1.5 0.8 3.4 Gooseberry. . . . 85 0.4 1.6 8.2 0.5 10.7 Strawberry. . . . 87.5 0.5 1.1 7.5 0.6 9.7 Strawb’y (wild) 87 0.6 1.3 4.6 0.6 7.1 Baspb’y (wild) 84 1.6 0.2 3.6 0.3 5.7 Baspberry .... 86.5 2.3 1.3 4.7 0.5 8.8 Currant . 85 0.5 1.8 6.4 .... 0.6 9.3 PROPORTION OF FOOD ELEMENTS. 371 In the foregoing table only the nutritive elements are given. In a few instances the proportions given will not aggregate one hundred parts, as the innutritions elements are left out. Proper Proportion of the Tarions Elements.— It will be ob¬ served by reference to the table of nutritive values that the proportion of the various elements varies considerably. Experiments upon both animals and human beings show that it is of great importance that the proportion of elements should be such as will best meet the demands of the system, especially in the case of the albuminous and carbonaceous elements (gluten, albumen, fats, starch, and sugar). Many and extended experiments and observations have shown that the proper proportion is about one part of nitrogenous or albuminous elements to seven parts of carbonaceous elements. From this it will at once appear that most articles of food are deficient in one or the other of these classes of elements, requiring that they be supplemented by other substances eaten with them. The following table shows the proportion of car¬ bonaceous elements to one of the albuminous in some of the more common articles of food, by the use of which any one will be able to combine various articles of food in such a manner as to secure just the right proportion of nutritive elements : — PROPORTION OF NITROGENOUS TO CARBONACEOUS ELEMENTS IN VARIOUS FOODS. Lean Beef, ALBUM. OR CARBONA- NITROG. CEOUS. 1 .5 ALBUM. OR CARBONA- NITROG. CEOUS. Wheat Meal or Eggs, i 1.0 Bread, 1 7.0 Peas, i . 2.7 Indian Meal, 1 7.7 Beans, i 2.7 Rye Meal, 1 9.8 Lentils, i 2.4 Potatoes, 1 10.7 Milk, i 3.6 Carrots, 1 11.5 Fat Beef, i 5.0 Barley Meal 1 12.7 Oatmeal, i 6.1 Rice, 1 13.0 By the above table it will be seen that wheat meal is the food which all single substances the most perfectly meets the requirements of the system, containing exactly seven parts of the carbonaceous ele¬ ments to one of the albuminous. Beef and eggs are deficient in the carbonaceous elements. Potatoes and most other vegetables, and rice, are deficient in albuminous ele¬ ments. Oatmeal has an excess of the albuminous elements. By com- 372 FOOD AND DIET. binina' food substances which are deficient in one class of elements with those in which the same class is in superabundant proportion, the two classes of elements may be furnished to the system in j ust the right pro¬ portion. For instance, lean beef, eggs, peas, beans, milk, or oatmeal, may be used with potatoes, rice, or other foods deficient in albuminous elements. It is for this reason that the Irish or Scotch laborer by in¬ stinct combines with his potatoes oatmeal porridge or buttermilk. For the convenience of the reader who may not wish to take the trouble to figure out the proper proportions of different foods necessary to furnish just the right amount of the albuminous elements, we have constructed the following table of combinations, which is sufficiently ac¬ curate for practical purposes (we have purposely omitted small fractions), and will be perfectly safe to follow, as we have taken care to have the albuminous, the most important element, in slight excess: — TABLE OF COMBINED FOODS. oz. LB. OZ. Combine 8* Lean Beef, . . . . . . With 4 8 66 n 66 66 1 8 66 H 66 66 1 8 66 12 Eggs, 66 1 6 66 9 66 6 6 5 2 66 3 pts , Milk, 66 1 66 91 66 66 66 4 4 66 *71 i w oz. Peas, 6 6 1 4 66 6 66 66 66 5 66 1 lb. 5 66 Oatmeal, 66 5 66 1 66 4 66 66 66 1 11 66 1 66 4 66 66 66 5 66 15 66 66 66 10 Potatoes. Rice. Indian Meal. Rice. Potatoes. Rice. Potatoes. Rice. Potatoes. Rice. Potatoes. Rye Meal. Indian Meal. The quantity of each kind of food given in the above table, when added to that of the food substance given on the same line hi the oppo¬ site column, makes just the quantity necessary to sustain life well for one day. Persons engaged in very active labor of course need more food than others, and the amounts may be increased accordingly, the same proportion being always preserved. It may be observed that it is not necessary to combine flesh with vegetable food in order to secure the proper proportion of the nitroge¬ nous and carbonaceous elements, since there are several vegetable foods which contain the albuminous elements in excess, which is also the case COMBINED FOODS. 373 with eggs and milk. For example, three pints of milk and one pound of rice make as perfect a combination, so far as the proportion of ele¬ ments is concerned, as seven and a half ounces of lean beef and a pound and a half of rice. Seven and one-half ounces of peas and a pound and a quarter of rice is an equally perfect combination of food elements, which may also be said of one pound five ounces of oatmeal and five ounces of rice ; one and a quarter pounds of oatmeal and one pound and eleven ounces of potatoes ; the same quantity of oatmeal and five ounces of rye meal ; or fifteen ounces of oatmeal and ten ounces of Indian meal. Bread is not included in the list of combinations, because it is a per¬ fect food by itself, and hence does not need to be combined with other foods, except for variety. This remark applies, of course, only to wheat- meal or graham bread. White or fine-flour bread is very deficient in albuminous elements. Another advantage in combining various foods is to be found in avoiding too great bulk in the case of vegetable foods, and too great concentration in the case of some animal foods. This will be readily ap¬ parent when it is observed how great quantities of some single food sub¬ stances are necessary to supply the system with the proper quantity of nitrogenous elements, when eaten alone, as shown by the follow table : — AMOUNT OF VARIOUS FOODS NECESSARY TO FURNISH T1 PROPER DAILY AMOUNT OF NITROGENOUS ELEMENTS. OUNCES. POUNDS Lean Meat, 15. G Grapes, 11.0 Eggs, 21.2 Apples, 2.5 Peas, 11.2 Peaches, oh- - 0< .0 Oatmeal, 23. G Plums, 37.5 Baker’s Bread, 3G.7 Cherries, 7.0 Wheat Flour (fine), 27.5 Carrots, 14.2 Graham Flour, 25.5 Turnips, 15.4 Indian Meal, 2G.8 Cabbage, 15.4 Rye Meal, 37.1 Parsnips, 1G.9 POUNDS. PINTS. Rice, 3.0 Milk, 4.5 Potatoes, 8.8 Beer, 185.0 By reference to the preceding tables any one will be able to so com¬ bine various articles of food as to secure the proper amount of nitrog¬ enous matter without overloading the digestive organs, and yet give I 374 FOOD AND DIET. to the food the bulk necessary for good digestion. Evidently, it would overtax the stomach to digest turnips in sufficient quantities to supply the wants of the body, while lean meat would afford an insufficient amount of bulk, as well as being deficient in carbonaceous matter. Popular Errors Relating to Diet.— Probably there is no sub¬ ject of importance relating to individual hygiene concerning which there are more erroneous notions entertained than respecting the matter of diet. How these errors have arisen, it is not in all cases possible to discover ; but in many cases it is too evident that the med¬ ical profession are responsible in a very great degree. Many times physicians do not take sufficient care to post themselves on the sub¬ ject of diet so as to be able to advise their patients wisely. The sub¬ ject receives far too little attention in our colleges ; and what little instruction is given in school physiologies and popular magazines is so mixed with error as to be practically useless. We will call attention to a few of these popular errors in as concise a manner as possible. 1. It is an error to suppose that the appetite is always a correct criterion of the quality and quantity of food. This is a widely prevalent error, and some very distinguished phy¬ sicians have given it countenance and indorsement by saying to pa¬ tients, when asked for a diet prescription, “ Eat whatever and when¬ ever you have a mind to.” No advice could be more mischievous. It virtually assumes either that there is no relation between diet and health, that it makes no difference what a person eats, or that the appetite is an infallible guide, both of which suppositions are palpably false. If all appetites were natural appetites, if there were no such thing as depraved taste, then might the appetite be relied upon ; but in the present state of things among civilized human beings scarcely one person in a hundred has a perfectly normal taste and appetite, if the number be not even smaller. The appetite is to some degree a guide, but it must be controlled and governed by common sense, by a knowledge of the laws of digestion and the relation of alimentary sub¬ stances to the stomach and the system. Either extreme on this point is bad. The appetite must not be ignored, and it must not be blindly followed unless it is known to be normal in its inclinations. It would be just as proper to advise a person to speak anything that comes into his mind, to do everything for which he has an inclination, and to thus follow implicitly all the promptings of his various organs, as to tell him to eat everything which he feels disposed to. POPULAR ERRORS IN DIET. 375 2. It is an error to suppose that sick persons whose appetites are poor should he tempted to eat by means of tidbits and dainties. Nothing is more common than for sick persons to be besieged with such unwholesome substances as preserves, rich jellies and sauces, pies, cakes, confectionery, etc. About as soon as a person is taken sick, in some communities, the neighbors begin to show their sympathy by contributions of all sorts of unwholesome and indigestible viands, and the invalid, whose stomach may be unable to digest any but the very simplest food, becomes a victim to the kindness of friends. Many times have the best efforts of the intelligent physician been baffled in this manner. “ Killed by kindness ” of this sort might be written on many a tombstone. The general belief that these things are essential for the sick when confessedly bad for the well is forcibly illustrated by the story concerning the old gentleman who arrived home late at night and not finding any pie in the cupboard awoke his wife with the exclamation, “ Why, what would you do if some one should be sick in the night ! ” Every physician ought to look carefully after this matter whenever he has a patient in charge, and the absurdity of the custom should be thoroughly exposed. The want of appetite in sick people, especially fever patients, is usually an indication that the stomach is not in a condition to digest food, if it is received, and only the most digestible should be given, and that in small quantities. 3. It is an error to suppose that children especially need large quantities of fat and sugar. The opinion has been gaining ground, of late, that fat and sugar are preventives of consumption when fed to children so as to increase their fat. From some considerable observation on the subject we are decid¬ edly of the opinion that the practice is a bad one and the theory upon which it is based wholly erroneous. These substances are themselves difficult of digestion (this is especially true of fat), and hinder the diges¬ tion of food, thus producing dyspepsia, which causes decay of the teeth and doubtless an equally marked deterioration hi other parts of the sys¬ tem. The notion that the appetite for sugar is a natural one is shown to be false by the fact stated by Dr. Anthony Carlisle, the Arctic trav¬ eler. According to Mr. Carlisle, the little folks in the vicinity of the North Pole are not fond of sweets. He says that when sugar was placed in their mouths they made wry faces and sputtered it out with disgust. There is no evidence whatever that it “preserves the teeth, “ aids digestion,” “ promotes growth,” or “ prevents consumption, as many persons believe. 376 FOOD AND DIET. 4. It is an error to suppose that many varieties of food are essen¬ tial to good digestion or nutrition. The common sense of most people who suffer with weak digestion has tauo-ht them that one or two kinds of food at a meal are much more O easily digested than a larger variety, notwithstanding the erroneous teaching of some popular authors on this subject. It is true that the ap¬ petite sometimes refuses food when its use is long continued without change; but the variety should be obtained by employing different foods or dishes at different meals rather than at the same meal. There is no doubt that dyspepsia is not infrequently the result of the indiscrim¬ inate gormandizing in which people indulge whose chief aim in eating is to gratifj' the palate. 5. It is a very great error to suppose that brain-workers, students, clergymen, lawyers, and other persons whose vocation is largely sed¬ entary, require but little food. The very opposite is true. A brain- worker uses up as much blood in three hours of intense labor as the muscle-worker in ten hours of or¬ dinary toil. Brain-workers should be well fed, but they must not be overfed. Many of the cases of apoplexy in professional men, set down to overwork, are really attributable to overeating. A brain-worker needs as much food and as nutritious food as a muscle-worker, but he is compelled to be more careful in its selection, and cannot exceed with im¬ punity the limits of his actual needs. This point is often neglected with reference to school-children, especially girls, who are not infrequently al¬ lowed to make the attempt to live and study hard on a slice or two of white bread and a cup of coffee for breakfast, bread and butter and pickles for dinner, and a morsel chiefly made up of “ dessert ” at night, when din¬ ner is taken at six, as in many of the large cities. In many female board¬ ing-schools the dietary is neglected, an insufficient amount of nourishing elements being furnished to support the vigorous mental effort required of students. Under such a regimen it is no wonder that many young women break down just when they ought to be enjoying the highest de¬ gree of health and strength. We are thoroughly convinced that a much larger share of the breakdowns among students, male as well as female, is due to poor feeding than to overstudy. 6. It is an error to suppose that fish or any other single article of diet is brain food, muscle food, or food for any particular part of the system. A few years ago a celebrated scientist made the casual suggestion POPULAR ERRORS IN DIET. 377 that perhaps fish food might be especially nourishing to the brain, as there was considerable phosphorus in the brain and also in the fish. The notion spread like a heresy, and soon fish of all sorts, big and little, scaly fish, shell-fish, and fish with neither scales nor shells, were devoured in unprecedented quantities by microcephalous people, and people whose brains were not obviously too small, for the purpose of obtaining the supposed specific effects of a fish diet. A gentleman eager to cultivate his brain and induce an increased growth, addressed a letter to a noted wag, asking for advice respecting the quantity of fish which he must eat per day. The answer he received was a fitting criticism on the theory, and undoubtedly discouraged the aspirations of the young man, being to the effect that a small whale would probably be about the right quan¬ tity for a meal. The falsity of the theory has been repeatedly shown by the citation of the fact that the lowest of all human races are those that live almost exclusively upon fish. In civilized countries, also, as in the vicinity of large fisheries, whole communities often make fish their almost exclusive diet; and yet there is no evidence that their mental capacity is increased thereby. In fact, the low mental and moral status of these people would furnish an argument on the opposite side of the question if it were necessarv to offer such argument. 7. It is cm error to suppose that people suffering with nervous de¬ bility, neurasthenia, or other forms of nervous weakness, need large quantities of flesh food. It is a very common custom when it is decided that a person has any form of nervous disorder accompanied by weakness or impaired nu¬ trition of the nervous system, to place him at once on a diet consisting largely of flesh, as beefsteak, mutton-chop, etc. Sometimes the drinking of blood is recommended. That this indiscriminate practice is a bad one we have often had occasion to notice. It not infrequently happens that the excessive use of flesh food is a cause of nervousness, as has been re¬ peatedly pointed out, and we believe that whether its use is advised or not, should depend on the condition of the stomach rather than on the nerves. A person whose stomach is very feeble may be unable to di¬ gest sufficient vegetable food to replenish his blood and fully nourish the tissues; for such persons a flesh diet or a mixed diet will be found to be very advantageous. 8. It is a most erroneous notion that “ rich food ” is strengthening The strengthening quality of food depends first upon its digestibility, 378 FOOD AND DIET. and second upon the proportion of albuminous elements which it con¬ tains. Sugar, fat, spices, and the other ingredients which are added to food in making it “ rich,” are of only secondary importance as nutritive elements, and in the case of condiments, of exceedingly doubtful value, if not wholly worthless. In the manner in which these substances are combined in “ rich food,” they are worse than worthless. Really rich food is that which contains a large proportion of the essential elements of food in a condition in which they may be easily assimilated. Graham bread, oatmeal mush, pea soup, baked beans, and kindred foods, are re¬ ally rich, and in the highest degree strengthening. 9. It is an error to suppose that persons engaged in laborious oc¬ cupations require a large amount of flesh food. Persons who labor hard, either physically or mentally, need a liberal supply of food rich in albuminous elements. These elements are fur¬ nished by such food as peas and beans in even larger quantities than in the best beefsteak. A pound of peas contains four ounces of albumi¬ nous elements, while a pound of beefsteak contains but about three ounces. Oatmeal and wheat meal are also very rich in albuminous ele¬ ments. The Scotch laborers who subsist very largely upon oatmeal por¬ ridge are said to be among the finest developed and hardiest men in the world. Numerous similar evidences in favor of a liberal supply of Vegetable food might be given. 10. It is an error to suppose that the system is better supported by meals at very frequent intervals than by food taken in accordance with the known time required for digestion. It has long been the custom to supply laborers undergoing severe exertion, as during harvest time among farmers, with two or three ex¬ tra meals during the day, thus often bringing meals within two or three hours of each other. We believe that the practice is a bad one, and that three meals at most are much better than more. The custom of eating five meals a day, common in some foreign countries, is certainly most unphysiological, and must be injurious. Children are often injured by too frequent feeding ; not only while infants, but after having grown up so as to be large enough to attend school, being very often supplied, by fond mothers, with luncheon for recess, and apples to eat at all hours. • It is a most unwise thing to allow children to form the habit of nibbling at food between meals. The fact that they are growing, and need a large supply of nourishment, is no apology for the practice, but rather makes it the more necessary that they should be regular in their habits POPULAR ERRORS IN DIET. 379 in order to secure good digestion. The stomach needs rest as well as the arms and limbs and other organs of the body. More food will be well digested with three meals than with a larger number, and hence a larger amount of good blood will be produced, and more healthy tissue formed. 11. It is an error to suppose that the best preparation and sup¬ port for extraordinary exertion is increasing the amount of food eaten proportionately. It is generally supposed that if a man has an unusually large day’s work to perform he must eat an unusually large breakfast and a pro¬ portionately large dinner. This is certainly an error. Large demands upon either the muscular or the nervous S37 stem for the time being de¬ tract from the power to digest. The stomach requires nervous energy to enable it to perform its function. If the nervous forces are other¬ wise engaged or used, they cannot be utilized in digestion. Hence it follows, theoretically, at least, that instead of giving the digestive organs an extra task in preparation for an extra effort, they should be required to perform less than the ordinary amount of labor. Experience as well as theory supports this view. Sir Isaac Newton, when employed in his most arduous labors, lived upon bread and water, and fasted for long intervals. General Elliot, the famous defender of Gibraltar, is said to have subsisted for a number of days on a little boiled rice. The won¬ derful “ L’homme Serpente ” of Paris, always fasted for twelve hours before attempting to perform his marvelous feats of agility. This plan not only secures a higher degree of efficiency in the effort made, but pre¬ vents, in great degree, the injury liable to result from excessive exertion. When required to overwork for a succession of days, we have found that we were not only able to perform much more work, but to do it with less effort at the time, and less exhaustion afterward, when taking a greatly reduced quantity of food than when attempting to do the same work and still taking the usual quantity of food. We have no doubt that a neglect of this precaution is a not infrequent cause of many of the sudden deaths of which we so often receive accounts, especially among politicians and public men. Overloading the stomach and over¬ working the brain at the same time is exceedingly dangerous. The man who overworks mentally must be temperate ; he must exercise the greatest moderation in his eating, and must to bill 3" discard all stimulants and narcotics. A great share of the cases of apoplexy which occur happen when the stomach is full. The increased clearness of intellect which results from abstemiousness well repays one for all the self-denial practiced. 380 FOOD AND DIET. VEGETABLE AND ANIMAL FOOD, There has been at various times, during the last century particu¬ larly, much and animated discussion of the question of vegetarianism. In England there exists at the present time an organization known as the Vegetarian Society, which was organized in 1847, since which time it has been actively engaged in gaining adherents to its rules, which re- Fig-. 149. Teeth of Carnivorous Animal. Fig. 150. Skull of Baboon. (Frugivorous.) quire entire abstinence from flesh-meats of all kinds. The society num¬ bers now nearly two thousand members, among whom are quite a num¬ ber of men of considerable distinction. In Philadelphia, there is a sect known as the “ Bible Christians ” who are vegetarians, and have been such for several generations. It is stated also that John Wesley, the founder of Methodism, was a vegetarian. Scattered through nearly all civilized countries there are persons who make no use of flesh food ; Fig. 151. Skull of Wild Boar. (Omnivorous.) Fig-. 152. Skull of a Rodent. and it is well known that the Brahmins and most of the natives of India abstain entirely from the use of flesh, from religious scruples. Several other nations, as the Chinese, Circassians, Swedes, Nor¬ wegians, Swiss, Italians, and even the Scotch and Irish, eat but little animal food. The question is an interesting one on account of its VEGETARIANISM. 381 moral, economic, and physiological bearings, and is well worth consid¬ ering. The arguments urged in favor of the preference for vegetable food are substantially as follows : — Figr. 153. Skull of the Chimpanzee. (Frugivorous.) 1. Man’s anatomical structure, especially the formation of his di¬ gestive apparatus, clearly associates him with the frugivorous class of animals, represented by the gorilla and chimpanzee, the lower orders which approach most nearly to the human form. This is clearly seen by an examination and comparison of man’s anatomical structure with that of animals belonging to the class referred to and those of the herbivorous, carnivorous, and omnivorous classes. This is admitted by the best comparative anatomists, and those who assert the con¬ trary give palpable evidence that they have not carefully studied the subject. The similarity relates particularly to the teeth, the move¬ ments of mastication or mode of chewing, the size of the salivary glands, and the pro¬ portionate length of the ali¬ mentary canal. The follow¬ ing quotations will suffice for authority on the subject: — Said the great naturalist, Linnaeus, in speaking of the dietetic character of man, “ His organization, when com¬ pared with that of other an¬ imals, shows that fruits and esculent vegetables constitute his most suitable food.” Baron Cuvier, an eminent authority on comparative anatomy, regarded as one of the most learned men that ever lived, states that “ The natural food of man, then, judging from his structure, appears to consist of fruits, roots, and esculent parts of vegetables.” Fig:. 154. The Human Skull. 382 FOOD AND DIET. Says Sir Everard Home, “ While mankind remained in a state of innocence there is every reason to believe that their only food was the produce of the vegetable kingdom.” Mr. Thomas Bell, lecturer on anatomy and the diseases of the teeth at Guy’s Hospital Medical College, London, Eng., says, “ The opinion which I venture to give has not been hastily formed, nor without what appeared to me sufficient grounds. It is not, I think, going too far to say that every fact connected with human organization goes to prove that man was formed a frugivorous animal.” 2. It is shown by numerous established historical facts that large portions of the human family have in ages past subsisted almost wholly, or entirely, upon vegetable food. It is well known that the early Grecians and Romans, as well as the still earlier Egyptians, were substantially vegetarian in their habits, while it is generally conceded that they enjoyed a degree of physical vigor far surpassing that pos¬ sessed by men of the present day ; and that they were not lacking in mental vigor is shown by the fact that among them were found men who devised philosophical systems which the world has been following ever since, and who laid the foundation for some of the most ab¬ struse and recondite of the sciences. 3. It is also shown that a large share of the present inhabitants of the globe subsist upon a dietary containing but a very small propor¬ tion of animal food, some of these same persons being the finest speci¬ mens of physical development to be found. 4. It is argued that experience proves that persons who subsist upon vegetable food are less liable to disease, longer-lived, capable of enduring more, and superior in development to those who employ flesh food. 5. It is shown by cases which are daily becoming more numerous, that animal food is exceedingly likely to communicate disease, through disease of the animals used for food, and through changes which meat often and rapidly undergoes after death. It is also shown that all flesh food is stimulating and in some degree clogging in character, on account of its containing the excrementitious principles, or waste prod¬ ucts, of the body, which are retained with the venous blood. 6. It is argued that as the Creator has supplied the human race with an abundance of nourishing vegetable foods, which are capable of maintaining life in its highest degree of perfection, the killing of ani¬ mals for food is unnecessary, and hence immoral. The moral argu- PYTHAGORAS OX FLESH-EATING. 333 ment is admirably presented by Ovid in his account of the teaching of Pythagoras, who was a vegetarian from religious scruples, together with his followers, believing hi the doctrine of metempsychosis, or the transmigration of souls. We quote the following passage from Ovid, respecting Pythagoras and his views : — He first the taste of flesh from tables drove, And argued well, if arguments could move : O mortals, from your fellows’ blood abstain, Nor taint your bodies with a food profane, While com and pulse by nature are bestowed, And planted orchards bend their willing load ; While labored gardens wholesome herbs produce, And teeming vines afford their generous juice ; Nor tardier fruits of cruder kind are lost, But tamed with fire, or mellowed by the frost ; ********* While earth not only can your needs supply, But, lavish of her store, provides for luxury ; A guiltless feast administers with ease, And without blood is prodigal to please. Wild beasts their maws with their slain brethren fill ; And yet not all, for some refuse to kill ; Sheep, goats, and oxen, and the nobler steed, On browse, and corn, and flowery meadows feed. Bears, tigers, wolves, the lion’s angry brood, Whom Heaven indued with principles of blood, He wisely sundered from the rest, to yell In forest, and in lonely caves to dwell ; Where stronger beasts oppress the weak by night, And all in prey and purple feasts delight. Oh, impious use ! to nature’s laws opposed, Where bowels are in other bowels closed ; Where, fattened by their fellows’ fat, they thrive ; Maintained by murder and by death, they live. ’Tis then for naught that mother earth provides The stores of all she shows, and all she hides, If men with fleshy morsels must be fed, And chaw with bloody teeth the breathing bread ; What else is this but to devour our guests, And barb’rously renew Cyclopean feasts ? We, by destroying life, our life sustain, And gorge the ungodly maw with meats obscene. Not so the golden age, who fed on fruit, Nor durst with bloody meals their mouths pollute. 384 FOOD AND DIET. Then birds in airy space might safely move, And timorous hares on heaths securely rove ; Nor needed fish the guileful hooks to fear, F or all was peaceful ; and that peace sincere. Whoever was the wretch (and cursed he he) That envied first our food’s simplicity, The essay of bloody feasts on brutes began, And after forged the sword to murder man— Had he the sharpened steel alone employed On beasts of prey that other beasts destroyed, Or man invaded with their fangs and paws, This had been justified by nature’s laws And self-defense : but who did feasts begin Of flesh, he stretched necessity to sin. To kill man-killers, man has lawful power, But not the extended license to devour. Ill habits gather by unseen degrees ; As brooks make rivers, rivers run to seas. The sow, with her broad snout, for rooting up The intrusted seed, was judged to spoil the crop, And intercept the sweating farmer’s hope : The covetous churl, of unforgiving kind, The offender to the bloody priest resigned : Her hunger was no plea ; for that she died. The goat came next in order to be tried : The goat had cropp’d the tendrils of the vine : In vengeance laity and clergy join, Where one has lost his profit, one his wine. Here was at least some shadow of offense ; The sheep was sacrificed on no pretense But meek, and unresisting innocence. A patient, useful creature, bom to bear The warm and woolly fleece that clothed her murderer ; And daily to give down the milk she bred, A tribute for the grass on which she fed. Living, both food and raiment she supplies, And is of least advantage when she dies. How did the toiling ox his death deserve, A downright simple drudge, and born to serve ? O tyrant ! with what justice canst thou hope The promise of the year, a generous crop, When thou destroy’st thy laboring steer, who tilled And ploughed with pains thy else ungrateful field ? From his yet reeking neck to draw the yoke, That neck with which the surly clods he broke ; PYTHAGORAS OX FLESH-EATING. 38 And to the hatchet yield thy husbandman, Who finished autumn, and the spring began. Nor this alone ! but Heaven itself to bribe, We to the gods our impious acts ascribe : ' First recompense with death their creatures’ toil ; Then call the blest above to share the spoil : The fairest victim must the powers appease, (So fatal ’tis sometimes, too much to please !) A purple fillet his bx-oad brows adorns, With flowery garlands crowned, and gilded horns : He hears the murderous prayer the priest prefers, But understands not ’tis his doom he hears : Beholds the meal betwixt his temples cast (The fruit and product of his labors past) ; And in the water views perhaps the knife, Uplifted to deprive him of his life ; Then broken up alive, his entrails sees Torn out, for priests to inspect the gods’ decrees. From whence, O mortal man, this gush of blood Have you dei’ived, and interdicted food ? Be taught by nie this dire delight to shun, Warned by my pi’ecepts, by my practice woxx : And when you eat the well-deserving beast, Think on the laborer of your field you feast ! ********* Ill customs by degrees to habits rise ; Ill habits soon become exalted vice. What more advance can mortals make in sin, So near perfection who with blood begin ? Deaf to the calf that lies beneath the knife, Looks up, and from her butcher begs her life ; Deaf to the harmless kid, that ere he dies, All methods to procure thy mercy tries, And imitates in vain thy children’s cries ? Where will he stop who feeds with household bread, Then eats the poultry which before he fed l Let plough thy steers, that when they lose their breath, To nature, not to thee, they may impute their death. Let goats for food their loaded udders lend, And sheep from winter cold thy sides defend ; But neither spi’ings, nor nets, nor snares employ, And be no more ingenious to destroy. Free as in air let birds on earth remain, Nor let insidious glue their wings constrain ; Nor opening hounds the trembling stag affright, Nor purple feathers intercept his flight ; 25 386 FOOD AND DIET. Nor hooks concealed in baits for fish prepare, Nor lines to heave them twinkling up in air. Take not away the life you cannot give ; For all things have an equal right to live : Kill noxious creatures, where ’tis sin to save ; ’Tis only just prerogative we have : But nourish life with vegetable food, And shun the sacrilegious taste of blood. In answer to these arguments, those who entertain opposite views urge the following among less important considerations : — 1. Though originally vegetarian in his habits, man has so long been accustomed to the use of animal food that it has come to be a necessity. 2. Those nations that use the most flesh, as for example the English, are the strongest and dominant nations. 3. The use of animal food is necessary to sustain life in the cold regions of the North, both on account of the absence of sufficient vege¬ table food and on account of the low temperature. 4. Confinement to the use of vegetable food would render man im¬ potent, and thus exterminate the race. 5. Animals were made to be eaten. 6. The doctrine of evolution proves that as man has developed from lower orders to his present condition he has found it necessary to employ a more concentrated diet. These arguments are met by counter-arguments, as follows : — 1. Long-continued violation of a principle cannot destroy it. The •dirt-eaters of the Orinoco River in South America have for ages been addicted to the habit of eating clay, but this in no way alters the fact that clay is not good for them, although they have become so accus¬ tomed to its use as to seem to be little inconvenienced by it. If flesh was not the best food for Adam, for the primitive Romans, Grecians, Persians, and Egyptians, it cannot be for modern man, whose organiza¬ tion is essentially the same. Examination of the remains of persons who died many thousands of years ago shows that there has been no radical change in the human organization within the knowledge of man. And again, experience shows that flesh food is not a necessity, since thousands have renounced its use, and, though suffering slight inconvenience at first, have improved under the change. 2. While it is true that the English nation makes large use of ani¬ mal food, and is at the same time one of the most powerful on the globe, AIKJ UMENTS ANSWERED. 387 it is also true that the lowest, most miserable classes of human beings, as the natives of Australia, and the inhabitants of Terra del Fuesro, subsist almost wholly upon flesh. It should also be borne in mind that it is only within a single generation that the common people of England have become large consumers of flesh. In former times, and when Eno- land was laying the foundation of her greatness, her sturdy yeomen ate less meat in a week or a month than the average Englishman of the present consumes in a single day. It is still true of the average Irish¬ man that he eats less flesh food in a week than the average Englishman o o eats in a day. Even more might be said of the stalwart Scotchman, whose chief article of diet is oatmeal. The Persians, the Grecians, and the Romans became ruling nations while vegetarians. Other influ¬ ences than diet are the chief factors in determining national supremacy. 3. That flesh food is not absolutely essential to sustain life in the Arctic regions is proven by the fact that the musk-ox, the reindeer, and other vegetable-eating animals flourish in those regions, although then- food is of the most scanty kind. Again, it should be remembered that the albuminous elements, which are most abundant in flesh food, are not those which supply the largest amount of heat to the body. The heat- producing elements are the carbonaceous, of which vegetable foods con¬ tain a large proportion in the form of starch, sugar, and fat. In the narrative of the expedition of the Polaris in the Arctic regions, a quota¬ tion from the journal of Captain Hall mentions that when traveling on foot among the ice and snow, within a few degrees of the North Pole, in the month of October, when the long, dark, cold winter night had al¬ ready begun, in company with his companions he lunched on graham crackers. Accounts are given of the enormous quantities of food eaten by the inhabitants of that cold country, which are supposed to be neces¬ sary to sustain animal heat, but that this is not so is proved by the fact that the crew of the Polaris maintained good health on a diet such as would not be considered extravagant for a laboring man in a mild cli¬ mate, and on two meals a day. It has been suggested, and evidently with much force, that the in¬ habitants of the Arctic regions are living in a very unnatural condition at the best, and that that region is manifestly not fitted for habitation by human beings. A cordial invitation is extended to them to move south. 4. The objection that the exclusive use of vegetable food would put an end to propagation is not sustained by evidence. It is cer- 388 FOOD AND DIET. tainly true that vegetable-eating nations are as prolific as others ; and it is also true that some of the most prolific of animals are vegetable- eaters. If the use of vegetable food should have a tendency to lessen the intensity of the reproductive or sexual instinct in man, it would probably be no detriment to the race ; and that it does have this ef¬ fect, experience seems to demonstrate. 5. The assertion that animals were made to be eaten, is an assump¬ tion for which the only evidence is the fact that man does eat animals. The idea so prevalent that everything created was for man’s special benefit is a most erroneous and pernicious one, as it leads human be¬ ings to overlook the fact that lower animals, although far below man in the scale of being, yet have rights which are as deserving of respect as his own, and which he is under obligations to regard. Each ani¬ mal as well as each plant has its particular use in the economy of nat¬ ure. There is no more reason to wonder what a sheep was made for, if not to eat, than to raise the same query concerning a mosquito or an earth-worm. 6. The doctrine of evolution can prove nothing respecting man’s diet ; for, as acknowledged by its most ardent supporters, it is but an hypothesis. It has not yet been proven, and it is not likely to be proven, that man was once a beast that kept company with gibbons and monkeys in the tree-tops of primeval forests. It is not necessary to consider any supposed argument founded on this basis until the doc¬ trine of evolution has itself been established by scientific and logical evidence. Testimony of Eminent Men. — The testimony of eminent men respecting the comparative merits of animal and vegetable food varies considerably, some asserting that a vegetable diet will not sustain life well, and others admitting that it is equal to flesh food in this particular. Says Dr. Carpenter, an eminent English physician and scientist, “ A well-selected vegetable diet is capable of producing the highest physical development.” Dr. Parkes, probably the most eminent of modern writers on hy¬ giene, says, “ The well-fed vegetable-eater will show, when in train¬ ing, no inferiority to the meat-eater.” Says Dr. Tyson, in an able article on “ Food and Drink ” in P>uck’s Hygiene, “ A diet too exclusively composed of animal flesh produces congestions and enlargements of the liver, and the so-called arthritic LEHMAN’S EXPERIMENTS. 380 or gouty diathesis . An excess of oleaginous food [always due to excess in use of animal fats] tends to produce the so-called bilious diathesis, characterized by excessive bile production and con¬ gestion of the liver.” The fact that animal food has a tendency to produce the gouty diathesis, urinary calculi, etc., is shown by the acidity of the urine in flesh-eaters. In the case of vegetable-eaters it is almost invariably alkaline. Says Dr. Edward Smith, one of the most eminent English writers on Food and Dietetics, “ Every element, whether mineral or organic, which is required for nutrition is found in the vegetable kingdom.” Lehman’s Experiments. — The well-known experiments of Leh¬ man show beyond question that the use of flesh food requires mere work of the kidneys than a vegetable diet. When living on an ex¬ clusively animal diet he found that the amount of urea eliminated by the kidneys was two and one-half times as much as when the diet was exclusively vegetable, and one and a half times as much when he par¬ took of both animal and vegetable food. This shows beyond ques¬ tion that when the diet is exclusively animal, the kidneys have more than double the amount of work to do than when it is vegetable in character, and that when partly animal and partly vegetable, they are required to do one-half additional and extra work. This excessive work must inevitably tend to the production of kidney disease, which is becoming a very common affection among the English and Amer¬ icans, who, as is well known, eat more animal food than any other civilized nations. Dietetic Importance of Meat Overestimated. — Dr. Pavy, one of the most eminent living writers on food, says : — “ The prevailing tendency, certainly in the English of the present day, is to give an undue weight to the value of animal food.” “ Against those who think that a large consumption of animal food is a sine qua non for the maintenance of health and strength, the ex¬ perience of vegetarians may be adduced.” In the effects of the Scotch prison dietaries, corroborative testi¬ mony is afforded. Dr. J. B. Thompson, resident surgeon to the Gen¬ eral Prison for Scotland, writing in the Medical Times and Gazette , 1808, after ten years’ experience with the same, speaks in high praise of a diet into which meat entered very sparingly, consisting chiefly of bread, oatmeal, barley, and milk, only one ounce of meat a day being 390 FOOD AJSTD DIET. allowed. Under this diet 88 per cent maintained their original weight or gained, notwithstanding the rigor of prison discipline. Dr. Edward Smith reports that it is not uncommon to find that among the agricultural laborers of Scotland [who are celebrated for their strength and endurance] no meat is consumed. Oatmeal is the principal diet of the sturdy Highlanders. Dr. Guy, who made extensive investigations of the dietaries in English prisons, in his report states, as one of the deductions from his observations, “ that we possess conclusive evidence of the sufficiency of a diet from which meat is wholly excluded, and even of a diet con¬ sisting wholly of vegetable matter.” A committee of the English House of Peers recently appointed to consider the question of diet in prisons, strongly advocated “ not only the great economical advantages, but also the superior nutritive value of a farinaceous diet over one of flesh.” The opinion seems to be gaining ground that animal food in large quantities is not good, and that human life can be well supported without it. If the English au¬ thorities try the experiment in their prisons, as it would seem prob¬ able that they may do, judging from the report referred to, we shall soon have a good opportunity of seeing vegetarianism tested on a large scale, and in such a manner as to secure conclusive results, or results which may be considered conclusive by those who are not con¬ vinced by the evidence already offered on the subject. Meat a Stimulant. — That meat is stimulating in its effects is de- duced from three admitted facts : 1. Flesh is known to contain ele¬ ments of an excrementitious character which cannot be used by the system, and when taken in must be expelled ; 2. A stimulant in the form of beef extract can be obtained from meat ; 3. Observation shows that its effects are stimulating in character. The pulse of a person who uses flesh food freely is well known to be more rapid than that of one whose diet is vegetable in character. Dr. Dundas Thompson, in a paper entitled, “Experimental Re¬ searches on the Food of Animals,” quotes the following account of the effects of eating meat upon a party of native Indians whose diet had previously been of a vegetable character : — “ They dined most luxuriously, stuffing themselves as if they were never to eat again. After an hour or two, to his [the traveler’s] great surprise and amusement, the expression of their countenances, their jabbering and gesticulations, showed clearly that the feast had pro- DIET OF THE IC EL AN. DEE. 391 duced the same effect as any intoxicating spirit or drug. The second treat was attended with the same result.” Dr. Druit, in describing before the London Obstetrical Society trie properties of beef essence, attributed to it rapid and remarkable stim¬ ulating effects upon the brain, and recommended it as a substitute for brandy in cases of great exhaustion and weakness. Dr. Edward Smith says of beef extract, “ It should be classed with such nervous stimulants as tea and coffee.” Liebig, the eminent German chemist, in an article in the London Lancet in 1869, wrote as follows : — “ It is essentially their food which makes carnivorous animals .... more combative than the herbivora which are their prey. A bear kept at the Anatomical Museum of Giessen showed a quiet, gentle nature, as long as he was fed exclusively on bread, but a few days’ feeding on meat made him vicious and even quite dangerous. That swine grow irascible by having flesh food given them is well known — so much so, indeed, that they will then attack men.” It is also known that blood-hounds will become dangerous by being fed on flesh. The following quotations from eminent authors respecting the diet of different nations and its effects, are interesting in this connection: — Animal Diet of Icelanders, and its Effects. — We quote the following from “ Mackenzie’s Travels in Iceland :” — “ The diet of the Icelanders consists almost solely of animal food, of which fish, either fresh or dried, form by far the largest proportion. During the summer they have milk and butter in considerable abun¬ dance ; but of bread and every other vegetable food there is the ut¬ most scarcity, and among the lower classes an almost entire privation. . As an effect of these circumstances in the mode of life of the Icelanders, cutaneous diseases, arising from a cachectic state of the body, are exceedingly frequent among them, and appear under some of their worst forms. Scurvy and leprosy are common in the island, occurring especially on the western coast, where the inhabitants de¬ pend chiefly upon fishing, and where the pastures are inferior in ex¬ tent and produce . Scurvy is observed to occur with greatest frequency at those periods when there has been a deficiency of food among the inhabitants, or when the snow and frost of the winter suc¬ ceed immediately to a wet autumnal season. For its cure, a vegetable diet is employed, in as far as the circumstances of the Icelanders will 392 FOOD AND DIET. allow of such means. „ . . . Inflammatory affections of the abdom¬ inal viscera are likewise very common among the Icelanders, chiefly, perhaps, in consequence of the peculiar diet to which they are accus¬ tomed. “ The diet of the Icelanders likewise gives much disposition to worms, and the ascarides are observed to be particularly frequent.” Raw-Meat Diet of the Ahyssinians, — The Abyssinians are very fond of raw meat which they cut from the living animal and eat while warm. Johnston, in his “ Travels in Southern Abyssinia,” says, “ Trav¬ elers who have witnessed their ‘ brunde ’ feasts can attest to the intox¬ icating effects of this kind of food, and they must have been aston¬ ished at th« immense quantities that can be eaten in the raw state compared to that when the meat is cooked, and at the insensibility which it sometimes produces.” Vegetable Diet of the Mexicans. — “Accustomed to uniform nourishment of an almost entirely vegetable nature, that of their maize and cereal gramina, the Indians would undoubtedly attain very great longevity if their constitutions were not weakened by drunkenness.” — Taylors Selections from Humboldt's Works relating to Mexico. Cannibalism. — Prof. Pavy remarks that “There is reason to believe that the practice of eating human flesh has not at all times been con¬ fined to the lowest savages, but it is difficult to obtain much satisfactory information respecting it. “There is little doubt that our ancestors, the ancient inhabitants of Britain, were guilty of eating human flesh, and St. Jerome specially charges the Attacotti, a people of ancient Scotland, with preferring the shepherd to his flock. “ There have been numerous instances of cannibalism among people suffering from starvation in sieges and from shipwreck, and the evidence is tolerably strong that some men belonging to civilized races, living in wild places, have occasionally decoyed persons to their dens and eaten them. Andrew Wyntoun, in his rhyming chronicle, charges a man who lived early in the fourteenth century with this crime. “ Lindsay, of Pitscottie, also relates that a man and his wife and fam¬ ily were all burnt on the east coast of Scotland for the crime of eating- children that they had stolen away. During the horrors of the great French Revolution the heart of the Princess Lamballe was plucked out of her body by one of the mob, taken by him to a restaurant, and there cooked and eaten.” DISEASED FOODS. 393 DISEASED FOODS, So many instances of poisoning, often fatal, from the use of food rendered unwholesome by disease are constantly occurring, that it is evidently important to give this subject due consideration. Prof. Gam- gee, of London, quoted by Dr. Letheby, health officer of the city of London, states that fully one-fifth of all the flesh sold in that great city is diseased. The amount of diseased food offered for sale in the city may be judged from the fact that more than four hundred tons of meat are sold daily in four of the principal markets. The means of inspection employed are so inadequate and inefficient that but a small fraction of the amount really unfit for food is discovered and seized. To this fact is attributed the remarkable increase in England O within the last few years of deaths from boils, carbuncle, and phleg¬ mon, the latter having increased to more than thirty-two times its former frequency. Experience abundantly shows that animals which die of disease are unfit for food, being liable to produce in those who eat their flesh symptoms of poisoning of all grades, from a mere trifling febrile dis¬ turbance to the most rapidly fatal effects. This danger has for ages been recognized by the Jews, whose laws require of them the most careful examination of all animals, both before and after killing, to in¬ sure soundness. The written laws given in the Bible do not include the more definite instructions on this point which are said by the Jews to have been given by Moses to the people orally, since which time they have been carefully observed. A Jew will not eat flesh which has not been inspected in the most careful manner by an officer called a searcher or bodek, appointed for the purpose, who is required to declare under the obligations of a solemn oath whether or not the animal which he examines is fit for food. A Jewish rabbi once in¬ formed us that in many of the large cities nineteen out of twenty animals thus examined were rejected as unfit for food. The rejected animals are sold to Christians, who are less scrupulous about the char¬ acter of their food, and in consequence are more subject to disease and are shorter lived than Jews. It is a common custom with farmers as soon as an animal shows symptoms of decline in health to send it to the butcher at once, or kill it and sell the meat themselves. When an epidemic among cattle is prevalent, the markets in the large cities are flooded with the flesh of 394 FOOD AND DIET . diseased animals. Thousands of animals are consumed every year as food, whose death was only a very little hastened by the butcher. There can be no doubt that a very large proportion of all the animal food sold in the markets is more or less contaminated by disease. Domestic animals suffer with diseases essentially the same as those from which man suffers ; and there is good evidence for be¬ lieving that in not a small number of instances the disease is commu- © nicated from animals to man. A trustworthy butcher informed us that not one in a hundred of the livers of hogs is found in a healthy condition. Often they are the seat of foul abscesses. The investigations and experiments of Dr. A. N. Bell, of New York City, as well as of eminent French experimenters, show that consumption is a very common disease among cattle, and that it is communicable from them to human be¬ ings. The president of the Board of Health of one of our large East¬ ern cities, and a professor of agriculture in one of the leading colleges - of the country, stated in our hearing that consumption is a great deal more common among cows than is generally known, and especially among blooded stock, which are generally more closely kept than common breeds. Very recently a case has been reported in which five hundred per¬ sons were stricken down with typhoid fever in consequence of eating the flesh of a calf, which, as was afterward ascertained, had died of typhoid fever. Every person who ate of the flesh of the calf was sick with the fever, the symptoms of which were characteristic, and quite a number died. Origin of Tape- Worm. — This troublesome and quite too common affection originates in the use of meat containing the young creatures inclosed in little cysts, or sacs. There are several varieties of the worm. One of the two most common, known as the tcenia solium , coming from the use of pork, the other from the use of beef. When taken into the system, the tiny embryos attach themselves to the mu¬ cous membrane of the intestine, and live and grow by absorbing the digested foods with which they are surrounded. They sometimes at¬ tain an enormous length, and give rise to many grave but often ob¬ scure symptoms. The only positive evidence of the presence of the worm, however, is the finding of portions of the parasite in the dis¬ charges from the bowels. The embryos of tcenia solium may be seen with the naked eye, TAPE-WORM. 395 looking like small bladders in the lean meat of pork, as shown in Fig. 155. In beef the cysts are too small to be readily seen with the un¬ aided eye. Flesh containing these creatures is said to be measly. This disease is very common in Ireland, where, according to good authorities, as large a proportion as three per cent of the hogs are affected. The disease is communicated to man by eating measly flesh without sufficient cooking to kill the embiyos ; hence it is most common among those who eat raw meat. Pork-packers and cooks are said to be most frequently affected with tape¬ worm, which is probably due to the habit of eating raw meat when about their work. Among the Abyssinians, whose regular diet is raw flesh, almost every per¬ son has a tape- worm. It was formerly supposed that the danger of acquiring this disagreeable ten¬ ant was wholly connected with the use of pork ; but the researches of Dr. Leidy, of Philadelphia, during the last fifteen years, recently made public, have shown that the variety of the worm which is ing Young Tape- Worms, most common is that caused by the use of raw beef. Of the many specimens examined by him he had never yet found one of the pork species. It need scarcely be suggested that in the light of these developments the use of raw flesh of any kind is dangerous and to be scrupulously avoided. No kind of flesh food should be used without exposure to a degree of heat at least as great as that of boiling water, and for a suf¬ ficient length of time to insure entire destruction to any living germ which may be lurking in it. Even then there is the constant liability of consuming cooked parasites along with the food, which will scarcely be considered appetizing. A very careful inspection should be made of all flesh food before it is eaten. This is required, as before stated, by the Jewish laws, and by municipal laws in some large cities ; but on the whole, the modern world is behind the ancient in this particular. In Rome, many centuries ago, public inspectors made a careful examination of all flesh foods before they were allowed to be sold. Dr. Leidy has also recently discovered that the cucumber, as Fig1, 155. Measly Pork contain- S9G FOOD AND DIET. well as pork and beef, is affected with tape-worm. He found in a cucumber a well-developed worm which had evidently grown there. The disease known as hydatids is caused by taking into the system the eggs of tape- worms instead of the young worms in flesh containing the cysts of hydatids. It is exactly the same disease in man known as measles in pork. Sometimes a person suffering with tape-worm be¬ comes infected. While the worm is in the intestines it is constantly giving off thousands of eggs, which are carried away with the bowel discharges, not being received into the system. Sometimes, however, through violent retching, some of the eggs are thrown up into the stomach, and then the person may become self-infected. The cysts may be formed in any part of the body. The liver is the most com¬ mon seat of hydatids in man. Occasionally the eye and the brain are invaded by them. In sheep the brain is the chief seat, producing the disease known as staggers. The Trichina. — See Plate IX. This parasite has been so often described that we hardly need enter upon a lengthy description here. For a long time after it was discovered, the general public received reports concerning the new parasite with incredulity; but so many cases of fatal poisoning from this source have now occurred that no one longer doubts. The trichina is found usually in pork, though it may infest the flesh of numerous other animals as well. Cases have been reported in England in which it was found in calves. It has also been recently discovered in the hippopotamus. It exists only in the lean flesh of animals, and is found among the muscular fibres, or inclosed in little sacs or capsules. It is almost always found in the latter condition. Ao found in these conditions -the parasite is a minute, thread-like worm, about -%j of an inch in length, and about of an inch in diameter. This is the embryonic or undeveloped form of the worm. When taken into the stomach by the eating of flesh containing it, the worm is soon liberated from its capsular prison, and in the course of a week undergoes complete development, reaching a size much greater than that described, so that it even becomes visible. During this time it is buried in the mucus of the stomach and intestines. When de¬ velopment is complete it speedily brings forth young in immense num¬ bers, a single worm producing, it is stated, one thousand or more young. The young worms very quickly begin to penetrate the .system, either by boring their way through the intestinal walls and Fig. 1. Fig-. 2. Fig:. 3. Figr. 4. Plate IX.—// UMA X PA PA SITES. Fig. 1. Trichina- lying loose among the muscular fibres as seen in a piece of ham newly infected. Fig. 2. Single Trichina in its capsule, some weeks after infection. Fig. 3. Head of a Tape-worm greatly magnified Fig 4 ThreadWorm. THE TRICHINA. 397 thence to the muscles, their final destination, or by getting into the blood-vessels and being swept along with the blood current. Which is the exact method, has not yet been determined. After reaching the muscles it penetrates the sheaths of the fibres, and finally becoming quiet, coils itself up and after a time becomes encapsulated, in which condition it is shown in the engraving, Fig. 15G. This was drawn by the aid of the camera lucicla, from a specimen found in a piece of pork sent to us by a gen¬ tleman in Wisconsin, who was led to suspect that a neighbor had been poi¬ soned with the parasite by the pecul¬ iarity of his symptoms, which puzzled the physicians in attendance. There were several deaths, but the cause was unsuspected, except by the gentleman referred to, until the pork was sent us for examination. The astonishing apa¬ thy of the people to the subject a few years ago was well illustrated by the fact that neither the poisoned family nor the attending physician would be¬ lieve the true nature of the case, even after we published an account of the examination, with a cut of some of the worms found, but persisted in calling the disease cholera morbus, though it occurred in mid-winter. After some months the walls of the capsules become impregnated with car¬ bonate of lime, when they appear like small, white specks, as seen in Figs. 157 and 158, which are readily seen by the naked eye. We frequently found these evidences of the presence of the worm in human muscles when dissecting as a med¬ ical student at Bellevue Hospital, New York. Prof. Jane way, then Demonstrator of Anatomy, informed us that he had observed the proportion of trichinatous bodies for a number of years, and believed that about one in twenty was thus affected. The worms were found still alive in cases in which they must have been encapsulated for Fig. 156. Trichinae— Two in a single Capsule. Highly Magnified. 308 FOOD AND DIET. flplg tm ,v 'v- 'Fig. 157. Meat con¬ taining Trichinae in Calcareous Cysts. Fig. 158. Same as Fig. 157. Enlarged. more than twenty years, so great is the vitality of these creatures. After they have once entered the tissues nothing can dislodge them ; they will remain as long as the individual lives. However, they do not, as some erroneously suppose, multiply after entering the muscles. They generate hut once, and in the intestinal canal. The entrance of this 'Iwti, parasite into the system, except when it is received in very small numbers, oc¬ casions a most serious dis¬ turbance of the vital func¬ tions. At first the symp¬ toms resemble those of cholera morbus, dysentery, or some other serious bowel disturbance. When the young worms begin to penetrate the system, the symptoms become more general, and simulate rheumatism, cerebro-spinal meningitis, typhoid fever, and other diseases. This is the reason why the malady is often over¬ looked. Indeed, there is reason for believing that the largest share of the cases of this disease are not detected. Whether or not death results, depends upon the number of parasites received into the system and the vitality of the patient. Heath usually occurs from exhaustion, but may be caused by paralysis of some of the mus¬ cles involved in respiration. That the disease is rapidly on the increase is shown by the fact that examinations of pork, made in Chicago, the greatest pork mart of the world, a number of years ago, showed the average number affected to be about one in forty. Re¬ cent examinations, made under the direction of the health officer of that city, show that at the present time one out of every twelve hogs packed in that city is infected with the disease. In some parts of the country a still higher percentage of infection is found. As there is no means of arresting the disease after a person or an animal has once been infected, it appears very probable that at no very distant date the hog race will be universally infected with this pest. Already it has been found necessary in most foreign countries open to the im¬ portation of American products to prohibit the reception of American pork. If a law were enacted in this country requiring that the rais- THE LIVER FLUKE. 399 ing of the beast and consumption of its carcass should be totally dis¬ continued, we doubt not that the result would be in the highest de¬ gree beneficial, and in no material degree damaging to the interests of the country. The special symptoms of trichinae poisoning, or trichiniasis, are fur¬ ther described in connection with the description of other diseases. The incurable character of the malady and the extreme liability of contracting it, seem to us to be ample grounds for discarding the use of pork altogether. The hog is well qualified to act the part of a scavenger, for which he was evidently by nature designed ; but there is plenty of food for human beings far superior in quality to swine’s flesh. The Liver Fluke. — This is a small parasite which, like the dreaded trichina, is common both in man and in animals which he frequently uses as food. It has been found in the squirrel, rabbit, dog, horse, and elephant, as well as in the sheep, the deer, and the ox. It is especially destructive to sheep, which seem to be more liable to it than most other animals, being frequently infested to such an extent that whole flocks are carried off by the disease to which it gives rise. It is stated that two million sheep die in England from this cause in a single year. Thousands of sheep annually die in this country from the same cause, without the real origin of the disease being suspected. The “ fluke ” is a very small creature, being flat and oval in shape, very much like a leaf. At one end is a thickened conical portion, in which are situated the head and mouth. When taken into the stom¬ ach, these parasites soon find their way into the gall duct, where they subsist and flourish with the bile for their food. In a short time, their increased numbers cause obstruction of the duct, which occasions absorption of the bile into the system, indicated by yellowness of the skin and, various other symptoms. The disease is known as the “rot,” or the “ liver rot." When first afl’ected with the disease, the sheep ap¬ pears very much like a person suffering with the jaundice. “In a short time the sheep fails, the skin and eyes become white and bloodless, a watery tumor appears beneath the jaws, the abdomen swells from dropsy, the wool becomes harsh and easily parts from the skin, and after lingering some time, the sheep dies, completely rotten, with ev¬ ery organ diseased.” This disease is very common among human beings in Iceland. It also occurs in this country. The natural history of the parasite is 400 FOOD AND DIET. very curious. The eggs, being discharged from the body through the bowels, are hatched in the water. After a time they develop into minute hydatids and attach themselves to small snails. Some of them also become attached to blades of grass, water-cress, etc. Sheep be¬ come affected by eating the snails or the hydatids with grass ; and there is good reason to believe that man becomes affected through eating water-cress and other aquatic plants. The Lung Parasite. — A curious worm is sometimes found in the luno-s of animals, known as the strongylus ftlaria. It gives rise to a disease resembling consumption in man, and hence must be a cause of serious deterioration to animals affected by it, rendering them wholly unfit for food. Bilious Beasts. — That animals are subject to conditions familiarly known among human beings as biliousness, jaundice, etc., is made evi¬ dent by indisputable facts. In examination of the carcasses of animals in the markets, very frequently one will be found in which the flesh has a golden tinge or distinct yellow hue. This is known to be the re¬ sult of some derangement of the liver, and it is a condition which is by no means uncommon. In France a regular business is made of producing diseased liver-:, geese being selected as the victims. This business is chiefly carried cn in Strasbourg, which has become world-famous for its goose-liver pies, known as pate de foie gras. The geese are shut up in a dark room, their feet nailed down to a plank, and often their eyes put out, so that they cannot exercise too much, and then they are regularly stuffed with corn and dough once in two hours, the food being crowded down the throat of the poor fowl with a stick. Antimony, a mineral poison closely allied to arsenic, is also fed to them for the purpose of increasing the diseased condition of the liver, by which means it is hoped to make it more tempting to French, English, and American gourmands. It re¬ quires about thirty quarts of corn to complete the stuffing process, by the end of which the poor geese are so nearly dead that it is certainly an act of mercy to kill them, their diseased livers having become so enlarged as to occupy almost the entire abdominal cavity. It would seem, however, much more appropriate that such creatures should be carried away by the public scavenger instead of being eaten as a deli¬ cacy by human beings. Parasites in Wild Game. — The idea is entertained by many per¬ sons that even if domestic animals are subject to such diseases as trl- PARASITES IN WILD GAME. 401 chiniasis, measles, etc., which render them unfit for food, wild animals, fowls, and game of all sorts, are free from this objection. That this is not the case is strongly suggested by the following paragraph, which recently (1880) appeared in the Forest and Stream, from the pen of a correspondent of that journal : — “ Through the kindness of a professional colleague I had the op¬ portunity of examining a wild duck (mallard) a few days ago, which wras, I think, of sufficient interest to warrant the begging of a few lines of your valuable space. The duck was infested with a large number of encysted parasites of the same general nature as the trichi¬ nae found in the muscles of pigs ; i. e., an encysted form of en- tozoa. It had been bought in the market by a gentleman, but when his cook came to prepare it for the spit, she noticed an unusual ap¬ pearance of the flesh of the breast, the skin being torn in one place, and called the master’s attention to it, and it was by him submitted to my friend, who, after sending out a piece cut from the heart to the Zoological Museum, at Cambridge, was kind enough to send the bird to me, knowing that I was interested in everything pertaining to field sports. “ The muscles of the duck were crowded with the encysted parasites, more especially the pectorals, and they seemed to be more numerous at the surface ; i. e., just under the skin. The cysts were from ^ to of an inch long by about -3V in width, being all very nearly of the same dimensions. They may be described as cylindrical, with rather bluntly rounded off ends, about the color of fat, or rather light-colored butter, and were imbedded in the muscles, between the fibres, with the long diameter parallel with the muscular fibres. I cannot think of any better well-known object to which to compare them than small pieces of that form of Italian paste which we call vermicelli. Their number may be appreciated when I say that in the space of a square inch on the breast, the skin of which had been stripped off, fifteen were seen on the surface. I have it at second hand, that Prof. Hagen, of the Museum at Cambridge, states that they are cysts of Psoms- permia, the immature, encysted stage of the Gregarinioe, and that he has never before known of these entozoa being found in the muscles of birds. “ If these parasites are capable of development in the intestinal tract of men, it ought to be known, as from the semi-cooked state in which we eat our ducks, the cysts would be very apt to be ingested 2G 402 FOOD AND DIET. without having their vitality destroyed. On the other hand, if as large and as numerous as in the specimen I saw, nobody, with eyes open, could fail to notice the presence of unusual bodies. “My object in making this communication is twofold: First, to get any scientific knowledge that your many scientific readers may be able to give on the subject ; and second, to find out from the sports¬ men whether the presence of these parasites has been previously no¬ ticed in ducks. So far I have not been able to hear of any similar case.” A note from Dr. Hagen, of Harvard University, addressed to the editor of the same paper, confirms the observation above described, and states that the Psorospermia is also very common in hams, about ten per cent of which are affected. In the ham the parasites are much smaller, and hence are not so easily discovered as in the duck. Dr. Hagen also mentions the discovery of disgusting parasites in bear- fiesh. He says, “ I received yesterday bear-flesh from the market. It contained in the cellular tissue next to the veins, cysts containing thin white worms, four inches long and less than one-twelfth thick. This is a very interesting parasite, described in 1G72 by Fr. Redi, It¬ aly, and since seen by nobody. Rudolphi quotes it as Strongylus ursi, and Diering as Nema toidium, but both only after Redi’s de¬ scription, which was made after the parasites of the European brown bear, which is the same species with our bear.” Effects on Animals of Abuse and Violent Exertion before Slaughtering. — The exhaustion and suffering incident to a long ride on the cars, often without sufficient food and water for days, or long drives in the hot sun, over dusty roads, producing a feverish condition of the system, is seriously damaging to the flesh as food. The same may be said of animals which become much excited while being slaughtered. Prof. Liebig gives an account of a family of five who were violently poisoned by eating the flesh of a deer which had been -caught in a trap and struggled violently before it was killed. The flesh of such animals is very tender, because decomposition really be¬ gins before the animal dies, so greatly are the tissues disintegrated. It is observed that the flesh of such animals decomposes very quickly, becoming putrescent much sooner than usual. It was once a custom in England to “ bait the bull,” that is, tease him with dogs, before slaughtering, so as to make the meat tender. The New Zealanders have a practice of hanging animals up by their hind legs and whip- DISEASED MILK. 403 ping them to death. This is said to make the tlesli very tender. Such practices are most inhuman ; and the use of such flesh must be in the highest degree injurious. Diseased and Poisoned 3Iilk. — Numerous experiments and ob¬ servations in this country and England show that milk may become a means of spreading disease far and wide in two ways: 1. By com¬ municating disease from diseased animals ; and, 2. By being the car¬ rier of contagions, infections, or other forms of germs by disease which is produced in those who make use of it. 1. It is now well established that the milk of ani¬ mals suffering with pulmonary ' disease or consumption will communicate the disease t o human beings as well as to other animals. The most serious consequences have resulted from the use of milk from animals affected with “ milk sickness,” “ foot-and-mouth disease,” the “trembles,” and various other maladies. In Figs. 159 and 160 may be seen a specimen of healthy milk compared with that which is diseased. 2. Many well-authenticated instances are recorded in which typhoid fever, diphtheria, scarlet fever, and possibly other diseases, have been spread over whole communities through the medium of milk. This has most often happened through the adulteration of milk with water con¬ taminated with the diseases mentioned, but cases have occurred when the only possible means of contamination was through the washing of the cans with impure or contaminated water. We are acquainted with the circumstances of an epidemic of typhoid fever in which we were able to trace the origin of a large proportion of the sixty cases which occurred to the use of milk from cows watered from a well in the barn-yard. Cases of mysterious poisoning occur not infrequently from the use of milk and cheese, the cause of which is still somewhat obscure. In response to a question respecting cases of this kind occurring in Wis¬ consin, Prof. Arnold remarked as follows in 1876 in the New York Tribune : — Healthy Milk. Diseased Milk. 404 FOOD AND DIET. “ Cases of poisoning similar to that described have been the occasion of much solicitude among dairymen and others, as they are every now and then breaking out in different parts of the country. Cases of a milder type are not infrequent, the symptoms running no further than nausea and pain in the stomach and bowels, without either vomiting or purging. I have satisfactorily traced the cause to organic poison in the milk, derived from the use of bad food and water taken by the cow. When water which is foul is permitted to stand where it is warm, or at a temperature at which organic changes can take place, organisms of one kind or another, poisonous to the human body, it is well known be¬ come developed, as is proved by the use of the water. Cows making use of such water are liable to take the poison germs into their circulat¬ ing system and excrete them in their milk. As in the processes of cheese-making the milk receives no treatment which will destroy them, they carry their vitality into the cheese, which, when eaten and dissolved in the stomach, sets them free to produce their legitimate results. When milk thus affected is used for butter, the poison is liable to and does ap¬ pear in the butter, producing the same symptoms as in the case of cheese. Or if the milk is used directly, exactly the same results follow as when made into butter or cheese. Dr. Inglehart, of Syracuse, N. Y., is now investigating a case of this kind. It is a case of poisoning in which a number of persons were affected precisely as in cases of poison cheese, and has been traced to the use of milk, and the milk traced to a herd of cows which had access to a cesspool in the yard and had their brewer’s grains moistened with water from a well affected by the drain¬ age in the yard. The writer has had personal experience in the use both of poison milk and poison cheese, and can identify their connection. This origin of the cause of the poison is supposed by some to be impossi¬ ble, because it is supposed impossible that organic germs could pass through the walls of the gland cells. But it has been rigidly demon¬ strated that germs which are taken in at the mouth come out in the milk alive, and afterward develop and multiply. (See “ Poison Cheese,” Seventh Annual Report of American Dairymen’s Association.) Cases of this kind are all the time occurring in dairy experience. Three cases have come to my knowledge within the past year where poisonous fer¬ ments taken in with the food of the cows have been developed in their milk and appeared in cheese and in butter and buttermilk. “It is useless to appeal to chemical analyses for the cause ; for the analysis kills the germs on which the poison depends, and of course it EFFECT OF DIET UPON ANIMAL FOODS. 405 eludes the chemist’s most careful work. Cases of mineral poison now and then occur from lead derived from the paint in the vessels used about the dairy, or from some other accidental circumstance. These the analyst can trace out with great exactness, but in cases of organic poi¬ sons his labors have been futile, and these cover the great majority of the cases of poison cheese, in which, I have no doubt, the poisoning hi Wisconsin is included. The cause of this kind of poisoning is a ferment, and has the nature of yeast. A little leavens all it is mixed with. The milk of a single cow will poison the largest vatful. The remedy is to keep all bad food and water out of the way, to remove the cause.” No doubt many of the cases of diarrhea and dysentery which are attributed to other causes, and frequently to harmless articles of food, might, by proper research, be traced to the cause pointed out above. The remedy indicated by Prof. Arnold is a good one, so far as it goes, but it is certain to be totally disregarded, in all but a very few cases, at least. A better remedy is to discard so questionable an article as cheese altogether, and to be very cautious about . the use of milk during the sum¬ mer months, or never to use it without first scalding- it. Effect of Diet upon Meat, Milk, and other Animal Foods. — The effect of food upon the flesh of animals in rendering it unwholesome has already been referred to in another connection. We wish only to call attention here to a few of the more common dangers. In certain parts of the country and at certain times of the year, the flesh and milk of cows is rendered unwholesome by their eating plants poisonous to hu¬ man beings. There is reason to believe that both the flesh and the eggs of fowls are affected in a similar manner, by the use of bad food. Both fowls and hogs are very apt to eat carrion and other foul substances which come in their way, which cannot be otherwise than detrimental to their flesh and to the eggs of fowls. This subject has re¬ ceived little or no attention, but we believe it to be important. It is well known that in certain parts of the country some varieties of birds, especially pheasants, are likely to be poisonous. This is said to be the case in Pennsylvania, where it is supposed to be due to their eating laurel buds. Fish of some kinds are sometimes poisonous at certain seasons of the year, and some varieties of fish are always poisonous, producing death when eaten, almost as quickly as prussic acid. Persons have been known to expire with a morsel of the fish in their mouths yet unswal¬ lowed. Danger of this kind is chiefly confined to the tropics. Another similar danger, but recently recognized, exists nearer home. 406 FOOD AND DIET. in the case of oysters, mussels, and various shell-fish. As is well known, these mollusks are the scavengers of the sea. They subsist upon the de¬ composing organic matters which they find in solution in the water in which they live. For greater convenience in marketing, extensive beds of oysters and clams are planted near large cities; and it not infrequently happens that they feed and fatten on the filth from sewers which empty into the sea in the vicinity of the beds, or which is brought to them by the tide. Not long since, the London Lancet called attention to this danger, stating that many cases of illness are undoubtedly attributable to the use of this unwholesome food. Shell-fish of all sorts are very poor food at the best, and are not worth the risk necessarily taken in eating them. In France and Belgium, oysters are made, if possible, still more un¬ wholesome by keeping them for several months in stagnant water until they become bloated and green, when they are served up to tickle the depraved palates of French gourmands. Such food cannot but be productive of injury to those who consume it, although the real cause of the maladies from which they suffer is sure to be overlooked. Violent poisoning from the eating of clams, oysters, snails, and lobsters, is not an uncommon occurrence. At a Sanitary Convention held in Detroit, Jan. 7 and 8, 1880, under the auspices of the State Board of Health, of Michigan, the first conven¬ tion of the kind in America, a physician of that city read a valuable pa¬ per on the supply of milk in cities, in which he called attention to the injury likely to result from the use of milk from cows fed on unwhole¬ some food. He remarked as follows on this point : — “ There is no doubt that much of the mortality of children can be set down as resulting from the use of adulterated milk, or what is j ust as bad, milk made from unwholesome food. The milk that a cow gives is largely determined by the food she eats, and in order to get good whole¬ some milk you must feed good wholesome food. If you feed swill, you must expect swill-milk.” Dr. Bell and others have shown that much of the infant mortality in New York City in past years has been due to the use of milk from cows fed on distillery slops, and known as swill-milk. We are convinced, by observation, that the evil is not confined to cities. We have often known farmers to feed their cows on the swill and slops from the house, and it is a very common thing to keep cows shut up in the summer time for weeks in inclosures where their only opportunity to quench their DISEASED VEGETABLE FOODS. 407 thirst is afforded by a stagnant, slime-covered mud-pool. Milk from cows kept under such conditions cannot but produce disease. It may also be mentioned here, perhaps, as well as elsewhere, that the treatment of cows must affect the character of milk in a marked degree. The ef- feet of anger in a mother upon a nursing child through changes in the milk are well known. It is then evident that ill treatment which may excite an animal to rage before or during milking may cause such changes in the milk as will affect the consumer cleleteriously. Children, whose power of resistance to morbid influences is much less than that of grown people, would be especially liable to injury from this source. Attention has also been recently called to the im¬ portance of securing healthy persons to milk cows and care for milk in connection with dairies, since it has been suggested, on very probable grounds, that one of the vilest and most ineradicable of all diseases may be communicated through the medium of milk by persons affected by the disease, especially when employed as milkers. Diseased Vegetable Foods. — Although more rarely affected by disease, some forms of vegetable food are subject to unnatural conditions which some¬ times become a serious cause of disease. Perhaps the most common and serious malady induced in this way is that known as ergotism, which results from the use of flour from what is termed spurred rye or wheat. Barley, rice, and other grains are also affected. Ergot is a fungus botanic-ally known as Claviceps purpurea, which in wet seasons grows upon the grains mentioned. Previous to the eight¬ eenth century the disease was much more common than it is now, since its cause is known and avoided. Extensive epidemics have occurred, which have sometimes been very fatal, the persons poisoned dying of exhaustion after suffering untold agonies from tetanic convulsions Fig-. 160. Spurred Eye or Ergot. Fig. 161- Ergot Grains Enlarged. Gangrene occurs in one form of the disease. lHigs. 1(51 and 162 are idustiations. 408 FOOD AND DIET. of this poisonous fungus. The presence of ergot in flour may be detected by the violet color, peculiar odor and flavor of the bread made from it, and by the following chemical test : Make a paste of the flour, and add a little dilute nitric acid. The appearance of a reel color is evi¬ dence of the presence of ergot. The addition of caustic potash should change the red to vio- let. Another method is to add caustic potash and heat the mixture. If ergot is present, it will be shown by a characteristic odor re¬ sembling that of her- O rings. © Dr. B. W. Richard¬ son of England holds that cerebrospinal 'meningitis, a most fa¬ tal malady, is due to ergot poisoning and to the use of bread made from grain affected with smut. A report of an made in 1875 by Dr. H. B. Baker, Secretary of the State Board of Health of Michigan, affords evidence in support of this view. Grain of this description should, of course, never be used for food. Pellagra, a disease which occurs particularly in Lombardy, is sup¬ posed to be due to the use of corn affected by a fungus. The skin be¬ comes dry and wrinkled, the mind and nervous system are powerfully affected, and convulsions occur similar to those observed in ergotism. Rust, Red-Rag, or Red-Gum, — A fungus growth which often affects wheat is known by each of the above names in various parts of this and other countries. There are grounds for suspicion that flour infested with this fungus is a cause of serious disease. Fig. 163 shows wheat flour which is infested by the spores of the rust fungus. Fig. 164 shows the mature plant. Smut Rolls, or Pepper Brand. — The spores seen in Fig. 165 rep¬ resent very fairly those produced by the fungus of that name, which is a later form of the rust fungus. epidemic of this disease, Fig'. 162 . Flour Infested with Rust, as seen under the Microscope. (Hassall.) ANIMAL PARASITES. 409 Animal Parasites. — The iveevil and midge are the most common parasitic in¬ sects destructive to grain. In the case of the weevil, the center of the grain is eaten by the insect, leaving merely a shell. The midge is injurious through the voracity of the yellow maggots or caterpillars that develop from eggs de¬ posited in the blossoms of the wheat, which is thus rendered worth¬ less, through the fail¬ ure to develop grains. Another very curi¬ ous parasite is ear- cockle , or pepper-corn, which is thus described by Hassall : u The grains affected turn green at first, and ul¬ timately black ; they become rounded, re¬ sembling a small pep¬ per-corn ; the husks are spread out and the awns twisted, by which means the in¬ fected ears are read¬ ily observable amongst the ' standing corn. The blighted grains are filled with a moist, Fig. 103. The Rust Fungus (Hassall). Fig. 164. Spores of Smut Bolls (Hassall). 410 FOOD AND DIET. cotton-like substance, and contain no flour. This substance is composed of myriads of eel-shaped animalcules, which, as soon as moistened with water, exhibit the most active movements. A most extraordinary cir¬ cumstance connected with these animalcules is that they may be so per¬ fectly dried that on the slightest touch they break up into powder, and yet, when moistened, they will revive and become as active as at first. This operation may even be repeated several times before the vitality of the animalcules is fully destroyed.” The Meal-Mite. — Damaged flour is often infested by mites very closely resembling the sugar-mite and its near relative, the itch-mite. One variety of this species of acarus is to be seen on Plate X, together with the sugar-mite. The Sugar-Mite. — Brown sugar is very liable to be infested with a parasitic insect closely resembling the itch-mite, of which it is a near relative, as well as of the acarus folliculorum, of the sebaceous follicles. It is known as the acarus sacchari. The disease known as grocers’ itch is produced by this insect, which burrows into the hands of those who handle the cheap grades of brown sugar, especially those known as raw sugars. The bisects cannot be seen without a microscope. A very good representation of the sugar-mite is shown in Plate X. Decayed Food. — It has been clearly shown by numerous cases, that the use of decayed or moldy food is dangerous to health and life. Prob¬ ably decayed flesh is the most dangerous. More than four hundred cases of poisoning from the use of moldy sausage have occurred in Wiir- temburg, Germany, within the last fifty years, one hundred and fifty of which have been fatal, from which it will be seen that the use of such food is in the highest decree dangerous. Cases of most severe poisoning have occurred from eating moldy bread, decayed cheese, milk which had been kept in cans not well cleaned, and canned meat which had undergone a species of decomposi¬ tion which cannot be detected by the smell or appearance, but which renders the meat extremely poisonous. Fish is much more apt to un¬ dergo this peculiar change than other kinds of food. As is well known, meat is much more tender and has a higher flavor after being kept sufficiently long after killing the animal to al¬ low decomposition to begin. When decay has progressed so far as to give to the flesh a distinctly putrescent odor, it is said to be “ high” Game of all sorts is usually eaten in this condition. In Europe it is generally customary to allow all meat to get very “ high ” before it is Platk X DECAYED FOOD. 411 considered fit for the table. In France the degree of putrescence de¬ sired is generally greater than in England. Many wild tribes much prefer their food in a state of decay. Decomposed fish, under the name of gnappee, is said to be considered by Burmese epicures as one of the choicest of dainties. The loathsome stuff is thus described by a correspondent of the London Times: — - “ This horrible mass of putrefaction is one of the choicest dainties of the Burmans. A quantity of fish, caught in the sea, is pickled, and then buried in the earth, and left there to attain the desired pitch of rottenness, for a time varying from one to four years, according to the taste of the particular market for which it is destined. Just as the wine manufacturers of Epernay and Rheims give to their cham¬ pagnes particular flavors to meet the various tastes of their clients, so the dealers in gnappee are said to prepare their delicate commodity. Whether kept for one or four years, it is absolutely putrid, and swarming with loathsome animal life. Not only do the Burmans love the horrible viand itself, but they actually revel in its effluvium, and the native passengers on the flats which carried it nestled and snuggled up to the vicinity of the nastiness, inhaling its stench with as much gusto as a hungry London gamin sniffs the odors of a cook- shop. Can human beings consume this loathsome putridity without suffering evil consequences ? I remember on the eve of my departure for a previous visit to India, that Mr. Jonathan Hutchinson, the emi¬ nent surgeon, asked me to observe, if I had the opportunity, whether the salt fish on which a large proportion of the population of the In¬ dian sea-board subsisted, appeared productive of any specific disorder. The opportunity for such an inquiry did not then offer itself ; but in Burmah there are two facts which may have some relation one with the other : that this putrid, pickled fish is an extensive article of consumption as human food, and that leprosy is so prevalent in the jail of Rangoon that it is found necessary to have a special ward for lepers.” The same writer also suggests that the destructive outbreak of plague which occurred in Astrachan was probably largely due to the use of this kind of food. While food which is far advanced in decomposition many times seems to be eaten with impunity, there is good reason, as intimated above, for believing that food of this character may be an active cause of loathsome and very fatal diseases. Not infrequently, too, acute and fatal poisoning occurs. 412 FOOD AND DIET. Serious sickness frequently arises from the use of stale eggs, espe¬ cially in the summer time, when it is often difficult to obtain eggs that are fresh.. During warm weather, eggs speedily undergo changes akin to putrefaction. The shell but partially protects its contents from the destructive action of germs, unless it is rendered impervious by the application of some substance capa¬ ble of filling the pores so that the air cannot pass through. An English' gen¬ tleman who has in¬ vestigated the subject quite thoroughly, finds, upon a careful microscopical exami¬ nation, that stale eggs often contain certain peculiar cells of a fun- Fi^. 165. Spores of Yeast Magnified. (Hassall.) gold character. These seem to be developed from the yolk of the egg, that portion which should furnish the material to form the flesh and bones of the chick which the egg would have produced by development under favorable conditions. Eggs containing these cells produced a poisonous effect upon dogs to which they were fed. We knew a case in which a whole family were seized with violent purging in consequence of the use of stale eggs ; at least the difficulty could be assigned to no other cause. Eggs grow lighter as they grow older, by the evaporation of their fluid contents, causing the internal portion to shrink. This leaves a small air space at one end, which becomes larger as the egg is older, and if it is very stale it will float when placed in water. Such eggs should be discarded as unfit for food. Rotten Clieese. — When fresh made, cheese is not an unwhole¬ some food, though rather difficult of digestion; but when it has passed through the process of curing, or maturing, which is really a YEAST A XT) MOLD. 413 process of decay, it is wholly unfit for food, being difficult of diges¬ tion, and likely to interfere with the digestion of other food. Some kinds of cheese, especially those of foreign make, as the limburger, is utterly loathsome to all unperverted tastes, and should on no account be eaten. Cheese often contains a peculiar grub, the larvm of a spe¬ cies of fly, commonly known as skippers or jumpers, from their jumping powers. If a man could leap as high in proportion to his length as a skip¬ per, he could easily spring over a steeple one ‘hundred feet high. Another parasite which infests cheese is known as the cheese-mite, which so closely resembles the itch-mite, or acarus scabiei, that it is not necessary to represent it. Yeast and Mold. — One of the most active agents in the production of decom¬ position is the yeast fungus, the spores of which are well shown in Fig. 16G, and the fully developed fungus in Fig. 1(>7. This is the effective agent in the fermentation of beer and wine, the raising of fermented bread, the “working” of cider, etc. It is the presence of many of the spores unaffected by the heat which renders the use of fer¬ mented bread objectionable in some cases of dyspepsia. Compressed yeast consists of the spores of the plant dried and compressed. With the aid of warmth and moisture, fermentation will take place sponta¬ neously, as the air constantly contains many of the yeast germs, or spores, which find ready access to fermentable substances and induce their pe¬ culiar process. Fig. 166. Yeast Fungus Magnified. (Hassall.) 414 FOOD AND DIET. Fig. 1G8 is a representation of the green mold so often seen on old cheese, stale bread, and other articles of food, as seen under a good micro¬ scope. It is by no means a harmless fungus, as the most serious illness has frequently resulted from the use of food affected with mold. In one case a whole family were poisoned by eating a pudding which con¬ tained a few pieces of stale and moldy bread. Stale Vegetables.— The use of stale vegeta¬ bles is often a cause of serious disturbance of the bowels, especially early in the season, when many kinds of vegetables are taken to market in an unripe and immature state. Vegetables and fruit keep fresh much longer than animal foods ; but when kept in the vi¬ cinity of strong and of¬ fensive odors they ab¬ sorb bad gases and may thus become unwholesome. Fruits and vegetables which have begun to decay are unfit for food. Potatoes and other vegetables which have begun to sprout much are not fit to be eaten. Potato sprouts contain a poison which may produce serious results, as it is of about the same nature as belladonna and other poisons of that class. Vegetables can be best kept in a wholesome condition by storing in a cool, dry place. The damp, dark vegetable cellars, usually located under a house or barn, are anything but wholesome. The vegetables rapidly deteriorate in quality, and the poisonous gases generated by decay ascend into the house to poison and sicken its inmates, as is well shown in Plate XV. Figr. 167. Green Mold of Old Cheese and Stale Bread. (Hassall.) MODES OF ADULTERATION. 415 ADULTERATIONS OF FOODS AND DRINKS. The present seems to be an age of fraud and deception, and in no direction is the prevailing tendency more manifest than in the adulter¬ ation of food. It would seem that of all forms of adulteration this would be the last to be thought of or perpetrated ; but so great is the cupidity of men in search of wealth that they do not hesitate to seize upon every opportunity for sophistication of food or drink of any de¬ scription, utterly regardless of the consequences to the consumers of the vile compounds. In many countries this evil has grown to such magnitude that it has by law been recognized as a criminal offense, to be visited with punishment when detected. Notwithstanding all laws, however, the nefarious business flourishes, and especially in a country like this, where there is as yet not adequate legislation to con¬ trol it. The punishment usually inflicted, when the crime is recog¬ nized and the offender tried and convicted, is so slight that there is no hesitancy in repeating the attempt to defraud the consumer, by sophisticating any article of food or drink he may purchase. We would suggest that an excellent means of punishment in many cases would be to compel the person found guilty of adulteration to con¬ sume the adulterated articles himself, and thus feel the actual effects of his crime. Such a mode of punishment would soon put a stop to the worst forms of adulteration, at least. Modes of Adulteration. — The different forms of adulteration may be classified as injurious, fraudulent, and accidental. In one or the other of these ways a large share of the articles employed as food or drink have been adulterated to the serious detriment of either the health or the pocket of consumers. Some of the more serious of these adulterations we will now notice, also describing, so far as may be practically useful, the best modes of detection. Hassall, in his very excellent work on the adulterations of food, enumerates the following formidable list of injurious substances act¬ ually found in different articles of food : — Cocculus Indicus, arsenite of copper, emerald green or Scheele’s green, sulphate of copper, or blue vitrol, acetate of copper, or verdigris, carbonate of copper, verditer, chromate of lead, red oxide of lead, Venetian red, bole Armenian, red and yellow ochres, umber, carbonate of lead, plumbago, or black-lead, bi-sulphuret of mercury, or cinnabar, sulphate of iron, cayenne, gamboge, chromate of potash, Brunswick 410 FOOD AND DIET. green, indigo, Prussian blue, Antwerp blue, ultramarine, alum, sul¬ phuric acid, and bronze powders, besides chalk, plaster of Paris, terra alba, and other substances in some degree injurious, though not act¬ ively poisonous. Let us now consider in detail some of the substances contaminated, and the modes of detecting the adulterants. Bread. — In this country, where good flour is usually moderate in price, adulteration of bread is not as common as in England and some other foreign countries ; there is no doubt, however, that adultera¬ tion is not uncommon even in this country, especially in the large cities, and particularly in the bread supplied to the poorer classes. The objects of the adulteration of bread are the production of a loaf of good appearance from inferior flour, and the retention of a large proportion of water so as to increase the weight, as in many cities the weight of loaves of a certain price is regulated by law. For this purpose alum is more frequently used than any other substance, as it produces the desired effect. Sulphate of copper has also been used, but seldom. Alum is very deleterious to the digestive organs, produc¬ ing bad dyspepsia when long used. Hence, its detection is important. The following is a simple method which any one can employ : — Detection of Alum in Bread. — The simplest method is to dip a slice of the suspected bread in a solution of logwood in water (either the extract or fresh chips may be employed). If alum is present, the bread will become a claret color. A more precise method is the fol¬ lowing. Macerate in three or four tablespoonfuls of water a half slice of .bread; strain off the water, and add to it twenty drops of a strong solution of logwood. Then add a large teaspoonful of a strong solu¬ tion of carbonate of ammonium. If alum is present, the mixture wall be changed from pink to a lavender-blue. This test will discover a grain of alum in a pound of bread. To Detect Blue Yitriol in Bread. — Dissolve some of the bread in warm water. Add a strong solution of prussiate of potash. If copper is present, a chocolate color will appear. Flour. — Wheat flour is sometimes adulterated with alum, ground rice, grit, and sand. Potato starch was formerly used, when flour was very high in price, but is now seldom or never employed for this pur¬ pose. Flour is sometimes contaminated with lead, which comes, to¬ gether with the grit and sand, from the wheat being ground with newly cut stones, and with stones the grinding faces of which have ADULTERATION OF BUTTER. 417 been repaired with lead. A number of cases of lead poisoning from this cause have been reported. Flour is also adulterated by admixt¬ ure with inferior grades, and with flour made from musty or grown wheat. Such flour should not be eaten. Alum may be detected in flour by the same method described for bread. The adulteration with rice and potato starch, with sand and metallic lead, may be detected by means of the microscope. Butter. — Formerly the only adulterants employed in butter were excess of salt, starch, and annatto, a peculiar coloring matter, which is itself often adulterated with gypsum, red lead, and blue vitriol. Within the last few years, however, an immense business has sprung up in the manufacture not only of adulterated butter, but of an arti¬ cle which is wholly counterfeit. This fraudulent article is known to the trade as oleomargarine butter; but the article is retailed to con¬ sumers as genuine. Immense quantities of lard and tallow are manu¬ factured into bogus butter in the larger cities of this country, as well as abroad. This artificial butter is often found to contain portions of flesh, membranes, and muscular tissue; and undoubtedly much of it is made from diseased hogs and cattle. It is highly probable that both tape- worm and trichinae may be communicated by this article. Fig. 1G8 shows the contrast between genuine and artificial butter as seen under the microscope, the only means of detection. The presence of annatto is shown by the unnaturally deep color of the butter. Other adulterants are easily detected by melting the butter with a gentle heat which causes them to separate. 27 418 FOOD AND DIET. Milk. — No article of food of general consumption is so frequently adulterated as this. The most common adulterant is water. It is said that chalk, annatto, burnt sugar, infusion of sheeps brains, and salt are also added in some cases. A fraud is also practiced in skim¬ ming the milk, or a part of it, before taking to market. The sub¬ stances commonly added are not often actually poisonous in them¬ selves, although numerous cases of typhoid fever have occurred, in which the disease was traced to the use of milk which had been adulterated with foul water. It is probable that diphtheria, and per¬ haps other diseases, are occasionally communicated in the same manner. Milk may also be contaminated with lead from the use of water con¬ taining this poison, and from standing in lead or zinc vessels. It is not always easy to detect adulterations in milk without a careful analysis ; but any unnatural appearance or unpleasant odor should cause it to be rejected at once. Milk should be purchased only of reliable parties, and careful inquiry should be made respecting the care of the animals from which it is produced, as one of the most dangerous means of adulterating milk is feeding cows upon unwhole¬ some food, and keeping them in close, foul, unventilated stalls. Under these circumstances, especially when the secretion is greatly prolonged beyond the natural period, as in cows known as “ farrow,” the milk secretion really becomes an excretory product, and contains quite a large proportion of the waste matters of the system. Such milk is totally unfit for human food, and when fed to children, especially, will be certain to produce very marked and disastrous results. Sugar. — The different varieties of sugar, sirup, and honey, are the subject of frequent and extensive adulteration. It has long been known that sugar could be manufactured from starch by boiling it for some time with dilute sulphuric acid. By a slight variation of the process, sugar can also be made from woody fibre of all sorts, as cotton, sawdust, shavings, etc. The sugar thus made is called glucose, as it closely resembles the sugar of grapes. It is much inferior to cane-sugar in sweetening properties, and does not crystallize, as does cane-sugar. It possesses chemical properties in several respects dif¬ ferent, by means of which it is readily distinguished. In the man¬ ufacture of glucose the sulphuric acid is neutralized by chalk, but as it is not always wholly removed, a portion may be retained in the sugar in a free state, as well as combined with iron in consequence of the contact of the acid with iron during the process of manufacture. ADULTERATION OF SIRUP. 419 On account of the non-crystallizable character of glucose it cannot be readily mixed with the coarse granular sugars, but it is used in large quanities in the fine granulated and pulverized sugars. The cheap grades of sugar have often been adulterated with plaster of Paris, sand, clay, bone-dust, and numerous similar sub¬ stances used to increase weight. Recently the astonishing discov¬ ery has been made that chloride of tin, an exceedingly poisonous salt, is used very extensively for the purpose of bleaching colored sugars, and is not wholly removed by the refining process. The presence of glucose in sugar can be easily detected by the fol¬ lowing method : Dissolve in a test-tube half a teaspoonful of the sus¬ pected sugar, in two teaspoonfuls of warm water. Add six or eight drops of a strong solution of blue vitriol. This will give to the solu¬ tion a faint blue tinge. Now add a solution of caustic potash. This will deepen the blue color greatly, and produce a curdy appear¬ ance. Continue to add the potash until the solution becomes clear, shaking the test-tube frequently so as to mix the contents well, and then heat to boiling in the flame of a spirit-lamp. If grape-sugar is present, as the liquid approaches the boiling point a yellowish color will appear, which will soon deepen to orange, then orange red, and deep red. The changes in color are due to the precipitation of red oxide of copper, which is the chemical test for grape-sugar. The inorganic adulterants of sugar mentioned can be readily de¬ tected by dissolving the sugar, when they will appear as a sediment. Sirup. — Sirups are still more extensively adulterated than sugars, as the fraud is much more easily covered in them. Seven years ago (1873), we examined a large number of specimens of sirup of every grade, varying in price from eighty cents to two dollars per gallon, and found ninety-five per cent of them grossly adulterated with sugar made from the refuse of corn-starch factories. Much of this kind of sirup is also made from potato starch. In the West there are several large firms exclusively engaged in the manufacture of artificial sugar from corn. Probably the most serious injury from the use of these sirups arises from the sulphuric acid which they contain, some¬ times in considerable quantity, besides quite large quantities of iron in some cases. We have known of instances in which serious injury has been done by this fraudulent stuff. A case is reported in which the cork of a jug of sirup was said to have been considerably corroded while on the way to a lumberman’s camp. In a case which came 420 FOOD AND DIET. under our observation a party of young persons had what was termed a “ candy pull,” making candy of sirup which had been purchased as “ golden drip.” The next morning every one who had eaten of the candy found his tongue and teeth as black as ink, from the action of the chemicals contained in the sirup. Such compounds must cer¬ tainly be wholly unfit to be put into the stomach of any human being. This fraud is not always easy to detect, but it may generally be dis¬ covered through the action of well-known chemical re-agents upon the sulphuric acid and iron which it is almost certain to contain. These substances may be detected by the following means : — Test for Iron. — It is well known that iron forms with tannic acid a black compound. It is by this means that ink is made from oak-bark or logwood and salts of iron. Hence by adding a little of the sirup to a solution of tannin, it will become black. Common tea contains tannin in sufficient quantity to make a good test. Into half a cup of moder¬ ately strong, clear tea put a teaspoonful of the sirup. If the tea be¬ comes black, iron is present in the sirup. It is true that the iron itself in very small quantities may not be productive of great injury, though hi the quantities in which we have found it we think it might do harm ; but a knowledge of its presence is of value as indicating the probable presence of sulphuric acid and of glucose. Sirup or sugar which will blacken tea may well be suspected and avoided. Test for Sulphuric Acid. — Procure at a drug-store a dram of nitrate or chloride of barium. Dissolve in a few spoonfuls of water. Dissolve some of the sirup in warm water in a test-tube or clear, clean vial. Add some of the barium solution and shake. Set aside for half an hour. If a white powder appear at the bottom of the vial as a sedi¬ ment, the sirup undoubtedly contains sulphuric acid, and should be rejected. The adulteration of sirups is so common that it is entirely unsafe to purchase or use the article, no matter how alluring its name or fine its appearance, without ascertaining its purity by careful testing. Adulterated and Artificial Honey. — A large share of the strained honey in market is adulterated with glucose, as well as are sirups. In some cases, so-called honey contains not a particle of the genuine article, being simply a flavored sirup of glucose. We have examined specimens in which considerable quantities of sulphuric acid were present. ARTIFICIAL HONEY— CANDY. 421 Unscrupulous men are in different parts of the country engaged in the manufacture of artificial honey from cane-sugar and various flavoring ingredients. We were informed by a gentleman not long since that in a Western State he had encountered a man who was traveling through the country selling a recipe for making artificial honey. W hen solicited to purchase, he very properly responded that he had nothing whatever to do with frauds of any kind. It is stated that another very ingenious form of adulteration of honey has been quite extensively practiced. What is termed the foundation of the comb is made of paraffine, a wax-like substance made from petroleum. This saves the bees much labor, as they have but to build up the cells on the foundation furnished them. Then, to still further economize their time and labor, they are abundantly supplied with glucose in solution, which they have but to transfer to the comb, thus avoiding the trouble of gathering sweets from distant fields. Of course no transformation takes place in the artificial sugar, it being simply transferred from the feeding vessel to the comb. Thus we have honey which is wholly artificial with the exception of a portion of the wax. This certainly caps the climax of adulterations. The tests for artificial and adulterated honey are the same as those for glucose in sirups. Candy. — Of all mixtures put into the stomach, probably candy is nearly, if not quite, the most thoroughly adulterated. With the ex¬ ception of rock candy, which is pure crystallized cane-sugar, there is probably no variety of candy which is not adulterated more or less. Very little cane-sugar is employed in its manufacture, it being chiefly composed of glucose. Considerable quantities of gypsum and terra alba are also used, especially in the cheaper grades. The flavoring substances employed are all artificial and unwholesome, often poison¬ ous. But the most deleterious adulterant used is found in the colors with which candies are made attractive to unsophisticated eyes. No less than twenty-four different coloring substances, mostly mineral, are employed, all of which are rank poisons. Numerous cases have occurred in which poisoning has been traced directly to colored can¬ dies, and in some instances death has occurred. We need not give directions for the detection of adulteration in candies, for all are bad, and should never be allowed to enter a human stomach. Children especially, should of all persons be forbidden these poisonous dainties. They would be harmful enough to warrant their 422 FOOD AND DIET. disuse if they were wholly pure; but as it is, they are absolutely dan¬ gerous ; and the manufacturers should be dealt with as foes to the public health. Adulteration of Baking-Powders. — The competition in trade and the cupidity of manufacturers, as might reasonably be expected in these days of wholesale and almost universal sophistication, has led to the wholesale adulteration of this widely used commodity. Some time since, Henry A. Mott, Ph. D., government chemist, made an ex¬ tensive series of analyses of baking-powders and published the re¬ sults, which showed that many of the most popular brands were largely adulterated with alum, the deleterious effects of which were well known. There was a great disturbance at once among the man¬ ufacturers of baking-powders, and it was not long before the attempt was made to convince the public that alum when used in this manner is in no way detrimental to health, it being claimed that the chem¬ ical reactions which take place when it is used in raising bread are such as to convert it into a different and wholly harmless substance. In order to answer these specious arguments conclusively and satis¬ factorily, Dr. Mott undertook an extended series of experiments with alum baking-powders upon animals. He selected healthy dogs and fed them upon biscuit made with the baking-powder. In every case the dogs became sick, some within a few hours, and others after a day or two. As a general rule they would scarcely touch the biscuit after the first day, preferring starvation to poisoned food. The principal symptoms arising from the use of the alum baking-powder were sick¬ ness, violent vomiting, loss of energy, and weakness of the limbs. The effects upon human beings have been shown to be, “headache, in¬ digestion, flatulence, constipation, diarrhea, dysentery, palpitation, and urinary calculi." Its effects upon young children are especially disas¬ trous, causing a great increase of mortality through the production of diarrhea. Among the numerous names of distinguished physicians who protest against the adulteration in cjuestion may be mentioned Dr. Willard Parker, Dr. Alonzo Clark, and Dr. Wm. A. Hammond. Dr. Mott’s experiments showed that alum interferes with digestion by rendering the gastric juice incapable of digesting food, and also causes congestion and inflammation of the mucous membrane of the stomach and bowels. By making an analysis of the internal organs of several dogs killed after being fed on biscuit made with alum powders for several days, he was able to detect it in considerable CANS ED FRUITS AND VEGETABLES. 423 quantities in the stomach, spleen, liver, heart, and other viscera, and also in the blood. Baking-powders are preferable to soda, saleratus, cream of tartar, and sour milk, in the way these substances are commonly used, and yet they can be avoided, and with benefit to the health. The alum powders are the worst of all compounds use for raising bread. They should never be employed. The presence of alum in baking-powders may.be detected by testing for alum the bread made from it, as al¬ ready directed. Cheese. — Like butter, cheese is now much adulterated by the oleo¬ margarine process. Much of it is made of skim-milk to which tallow has been added to replace the cream removed. There is no means by which the fraud can be detected. Cheese is often colored with an- natto, by which it is frequently rendered poisonous from adulteration of the coloring matter with red lead and salts of copper. Persons have been seriously poisoned by eating cheese rendered unwholesome in this way. The rind of cheese is often extremely poisonous, in con¬ sequence of having been washed with a solution of corrosive sublimate to prevent the attacks of insects. Mercury has frequently been found in the rind of cheese. Canned Fruits and Yegetables. — Canned fruits and vegetables are often adulterated with coloring and flavoring substances of an un¬ wholesome character. The most common are red coloring matters in tomatoes (not very common in this country), fuchsine and aniline in fruits, and salts of copper in peas and other green vegetables. It occa¬ sionally happens, also, that the solder with which the cans are closed causes contamination of fruits with lead. Sometimes the cans them¬ selves are a still greater source of danger, being made of lead-tin. Within the last few years a recipe for preserving fruits has been widely sold which consisted in exposing the fruit to the fumes of burn¬ ing sulphur, or immersing it in water which had become impregnated with sulphurous acid by such exposure. The deleterious influence of such a preservative is well shown by the fact that it destroys the color of fruit exposed to its action, and deprives it of its finest aromatic flavors. It should never be employed. The plan is not a new one, though pre¬ sented as such. It has been well known for many years, perhaps cent¬ uries. Salicylic acid has been suggested as a preservative ; but the quantities in which it would need to be used would render articles pre¬ served with it unwholesome as food. 424 FOOD AND DIET. When the coloring matter is of an earthy character, some portions may he found in the bottom of the can as sediment. When fuchsine or aniline is present, it may be detected by placing in the juice of the fruit, as found in the can, a few threads of white woolen yarn or worsted. After half an hour remove the threads, and if the coloring matters mentioned are present they will be colored red, as will not be the case if only the fruit j uices are present. Adulteration with copper may be strongly suspected if such vegetables as peas have a bright green appearance. The presence of copper will be proven if a bright strip of iron or a sewing-needle placed in the can over night, after adding a few drops of sulphuric acid, is found to be coated with a coppery-colored film in the morning. A very small pro¬ portion of copper may be detected in this way. Preserves, Marmalade, etc. — A large share of the preserves man¬ ufactured for the retail trade are adulterated more or less in one way or another. It is customary to make into preserves inferior fruit, or that which has spoiled by too long keeping, or is otherwise unfit for sale. In many cases, preserves are colored with fuchsine and aniline, as are some canned fruits. Marmalade often consists chiefly of apples flavored with orange essence. Copper is also sometimes found, as in canned fruits. It is usually accidental, however, its presence being due to the fact that preserves are generally made in copper kettles, some of the -copper being dissolved by the juices of the fruits, the solution of the -copper being facilitated by the heat and the stirring. On this account, preserves should never be made in copper kettles. “ Marbleized iron¬ ware” should also be avoided, as it is dangerous on account of the presence of lead in the enamel. Jellies. — It is rare to find in the market such a thing as pure fruit jelly. If found, it will be held at a high price. The ordinary jellies sold are largely made up of gelatine, colored with aniline and other dye-stuffs, and flavored with various essences. Many of them contain not a particle of the fruit after which they are named. A less harmful but no less fraudulent form of adulteration is the use of apple jelly, flavored to suit the different varieties for which it is sold. The coloring matters may be detected by the method already' de- scribed ; but as so few are pure, it is best to avoid them altogether. Fruit Extracts. — The science of chemistry has lent its aid to the .art of adulteration so effectually that almost, if not quite, every one of CANNED AND POTTED MEATS. 425 the principal fruit flavors is imitated by chemical compounds so closely that the difference cannot be detected by the taste, though, undoubtedly, the difference is readily noticed by the stomach. The following description of the composition of some of the principal fla¬ voring extracts we condense from a report on the subject in the An¬ nual Report of the Massachusetts Board of Health for 1873 : — Pine-apple essence is a solution in alcohol of butyric ether, which is made by distilling butyric acid with alcohol and oil of vitriol. The butyric acid is made from decayed cheese. Quince essence is a solution in alcohol of an ether obtained by treating .oil of rue with aqua fortis, and digesting with alcohol the acid thus obtained. Pear essence is made by distilling a mixture composed of fusel-oil, acetate of potash, and strong sulphuric acid, or oil of vitriol, and mix¬ ing the product with alcohol. Apple essence is made from sulphuric acid, fusel-oil, and valerianic acid. The flavor of currants, bananas, raspberries, strawberries, etc., is imitated by mixing the various ethers known to chemistry, and com¬ bining with them camphor, acetic acid, vanilla, and the various essen¬ tial oils. Not only are these essences sold at retail for domestic use, but they are largely, in fact almost exclusively, used by bakers and con¬ fectioners. Pastry, jellies, and ices are made still more atrocious by the addition of these abominable mixtures. Serious illness and even death has frequently been caused by the use of articles containing the poisonous substances above mentioned. A perusal of the above will be sufficient to satisfy any one that the so-called fruit essences are not suitable substances to be mingled with food. Sirups flavored with, these essences are usually employed in the preparation of soda-water, a fact which certainly makes the use of this popular summer beverage exceedingly questionable. Can¬ dies also are flavored with the same vile compounds, together with jellies, as before mentioned. Canned and Potted Meats.— Canned fish and other meats are often in a condition unfit for food when put up, and are further de¬ teriorated by a peculiar kind of decomposition which it is scarcely possible to discover by examination, but which often produces most serious consequences when the meat is eaten. This condition of the 426 FOOD AND DIET. contents of a can may be best determined before the can is opened, by observing whether the end bulges outward or is drawn in. If there is bulging, the meat is bad. Potted meats are often colored for the purpose of hiding dirt, or to give the cooked meat a more lively appearance. All such meats are particularly unwholesome. It has been discovered through the testimony of a manufacturer that large quantities of horses’ tongues and Hanks are worked up into potted meats as beef. It has been known for a long time that sausages are often adulter¬ ated with horse-flesh, as well as that of dogs and other animals. A year or two ago the discovery was made in San Franciscp that a prominent sausage-maker of that city was in the habit of working into his sausages large quantities of cat-flesh. This fact was discov¬ ered by the lai'ge number of cats which he was known to receive daily, and was acknowledged by him in court. We can hardly re¬ gard these additions as making the article any worse than it is orig¬ inally, since we can imagine no animal whose flesh would be likely to be more unwholesome than that of the swine. Vinegar and Pickles. — Vinegar is very often adulterated with mineral acids, sulphuric acid being the most commonly used. Many specimens of vinegar offered for sale as cider vinegar have not a drop of apple juice in them. Vinegar is itself an unwholesome article; but it becomes tenfold more injurious when adulterated with strong acids, injuring not only the stomach but the teeth. The presence of sul¬ phuric acid, or oil of vitriol, may be detected by the test given for this acid in sirups. It is said that it may also be detected in the follow¬ ing manner : Add to the vinegar a small quantity of sugar. Then put a drop or two on a clean plate and evaporate at a low heat. If the acid is present, the spot will become black, through its action on the sugar. The following is a recently devised, and probably the best, test for mineral acids in vinegar : Pour into a test-tube or small vial two to four teaspoonfuls of the vinegar to be tested. Add twenty or thirty drops of a strong solution of salicylate of soda. If mineral acids are present, the salicylic acid will be separated from the soda and will appear in the form of curds. The salicylate of soda may be ob¬ tained at any drug-store. A dram will be sufficient to test several samples of vinegar. The chloride-of-barium test may also be used. TEA AND COFFEE. 427 Pickles are of course liable to contamination with the same acid to be found in vinegar, and in addition are subject to a very danger¬ ous form of adulteration, the addition of some salt of copper to deepen the color. Very green pickles are sure to have more or less copper in their composition. The copper is sometimes added, perhaps more often derived from the copper kettle in which the pickles are made, through the action of the acid of the vinegar upon the copper. It is customary to make pickles in brass kettles for the purpose of giving them a green color. Some cook-books even recommend that a few copper pennies be boiled in the kettle with the pickles for the pur¬ pose of “ greening ” them. The practice is not only a most absurd one, since it in no way adds to the flavor of the pickles, but is very dan¬ gerous. Pickles are unwholesome and indigestible at the best ; and when poisoned in this manner they become about the worst articles which can be put into the stomach. Copper and brass kettles should never be used in any way in connection with cookery. The presence of copper in pickles may be easily detected by put¬ ting a clean bright iron wire for a few hours into the bottle contain- ing them. If copper is present, it will appear as a thin film upon the wire. Lemon and Lime Juice. — These valuable acids, sometimes pre¬ served in the form of the juices of the fruits from which they are ob¬ tained, are not infrequently adulterated with sulphuric acid, which is intensely sour, and is also an active chemical poison. Sulphuric acid is not infrequently used by those who sell cheap lemonade at stands in the cities, as it is a much cheaper acid than lemon. We have known of instances in which serious poisoning has occurred from drinking this kind of lemonade which had been made in a zinc water- cooler, the poisoning being occasioned by the zinc. Test with chloride of barium. “ Salts of lemon” sold in the market is a dangerous poison consisting of oxalic acid. © Tea and Coffee. — These substances, used as beverages in infusion, are largely adulterated, though in the case of coflee the adulterants em¬ ployed are not worse than the original substance. Tea is, however, rendered even more unwholesome than it naturally is, by the addition to it of Prussian blue, and various other harmful substances. It is a fact worth remarking, that Chinamen in this country will not drink the tea which is imported from their country for American consumers. 428 FOOD AND DIET. alleging, when questioned, that it is impure, they being evidently aware of the general practice of adulteration for foreign exportation. The chief adulterants of tea are the leaves of other plants — as of the sycamore, horse-chestnut, plum, beech, plane, elm, poplar, willow, oak, hawthorn — exhausted tea leaves, lie tea, sand, quartz, oxide of iron, iron filings, starch, black-lead, gum, indigo, Prussian blue, turmeric, Chinese yellow, China clay, soapstone, French chalk, mica, gypsum, rose pink, Dutch pink, chrome yellow, Venetian red, carbonate of cop¬ per, arsenite of copper (Paris green), bichromate of potash, carbonates of lime and magnesia, copperas, catechu, etc. The detection of the leaves of other plants is comparatively easy. The tea should be soaked in warm water for an hour or two, when they can be unrolled and spread out upon a pane of glass and com¬ pared with the genuine leaves shown on Plate XI, on which, and on Plate XII, are also shown some of the more common leaves employed in the adulteration of tea. Leaves that have been once used, and treated with gum to give them the appearance of the genuine, may be detected by their unnaturally glossy appearance. The roll is also less regular than that of unused tea. Lie tea is composed of fragments of tea leaves, exhausted leaves, dirt, coloring matter, etc., held together by boiled starch. The fraud may be easily detected by soaking the sample a few minutes in boil¬ ing water. The small masses, instead of unrolling, as in genuine tea, dissolve into small, dirty particles. Iron oxide and iron filings may be easily detected by means of a magnet. When a magnet is plunged into the tea, small particles adhere to it. By repeating the process, removing the adhering parti¬ cles each time, all the iron may be removed from the tea. Prussian blue, indigo, black-lead, gypsum, turmeric, and various other substances used as facing, may be easily detected by either one of the following methods : — Place two or three ounces of the tea in a piece of thin muslin and shake well over a piece of white paper. Examine the dust thus col¬ lected with a magnifying glass, capable of enlarging ten or fifteen diameters. An ordinary botanizing glass answers the purpose admira¬ bly. Prussian blue appears as brilliantly blue, transparent, angular particles. Indigo particles are greenish blue and opaque. Another method is to wash a few ounces of tea with cold water, placing the washings in a glass to settle. Examine the sediment in the manner directed. D A. Wild Plum; B. Elder; C. Elm; D. Tea leaf; E. Young leaf; F. Leaf partly grown ; G. Tea- leaf of green variety. Plate XI. GENUINE LEAVES OF TEA AND LEAVES USED IN ITS ADULTERATION. A. Hawthorn ; B; Beech; C. Oak; D. Plane; E. Willow; F. Poplar. Plate XII. LEAVES USED IN ADULTERATION OF TEA. ADULTER A TION OF COFFEE. 429 Black-lead, turmeric, mica, sand, and most other adulterants, may also be detected by examining the dust or sediment with a magnify¬ ing glass. The presence of gypsum is shown as follows : Add to some of the sediment, in a test-tube, a few drops of muriatic acid ; add a little water, and then a few drops of a solution of chloride of barium. If a white precipitate appears, it is evidence that the tea has been adulterated with sulphate of lime. Adulteration of Coffee, and Modes of Detection.— The most extensively used adulterant of coffee is chicory, a fleshy root. This is found not only in ground coffee, but in coffee berries, the chicory being molded into the form of coffee berries by means of machinery for the purpose. Chicory is not a poisonous substance, and is wholly devoid of narcotic or stimulating properties. Ground coffee is univer¬ sally adulterated, not one specimen in ten, according to most reliable authorities, containing a particle of genuine coffee. Peas, beans, acorns, wheat, rye, barley, bran, carrots, parsnips, chefus-nut, almond shells, sawdust, oak bark, exhausted tan bark, and many similar sub¬ stances, are used in adulterating coffee, being roasted and ground, and sold in packages. Burnt sugar and molasses are used to flavor and color these various substances. Venetian red is also used for coloring;. Essence of coffee consists almost wholly of burnt molasses. Bate stones have recently been employed in the adulteration of coffee in large quantities, and, according to Hassall, this beverage, so much prized by millions of the human race, is in some parts of England and the East adulterated with the livers of horses and cattle, which are roasted and ground for the purpose. Nearly all the substances used in the adulteration of coffee may be detected by means of the microscope. The following simple means are also usually sufficient to determine the character of any specimen of coffee : — 1. Notice if the ground coffee cakes in the paper or package con¬ taining it or when pressed between the fingers. If it does, it is spu¬ rious. 2. Place a few pinches upon water in a goblet. If part floats while another portion sinks, it is adulterated. Pure coffee absorbs water slowly and so floats for some time, while the substances used to adulterate it absorb water quickly and sink. The amount of adulter¬ ation can be readily estimated by observing what proportion sinks readily. 430 FOOD AND DIET. 3. Moisten a few grains of the coffee spread out on a piece of glass. If small particles can be picked out which are so soft that they can be easily mashed between the fingers, the coffee is adulterated. 4. If water into which ground coffee is placed quickly becomes deeply colored, the sample is adulterated, since pure coffee colors water slowly. Cayenne Pepper. — Though not an article of food, and an un¬ wholesome condiment, cayenne is the subject of a dangerous form of adulteration. In order to add weight, ground rice, and other sub¬ stances, are employed; and then to produce the required intensity of color, red lead and vermilion or bi-sulphuret of mercury, both very poisonous substances, are used. We mention this fact as an addi¬ tional inducement for abstaining from the use of cayenne as well as other condiments. Artificial Cider . — In the West, large quantities of a mixture called cider are made by compounding sugar, tartaric acid, and yeast, and allowing fermentation to take place. It is a harmful beverage. Adulteration of Till. — On account of the increased cheapness and convenience of manufacture, a large share of the tin plate made at the present time contains in it a large proportion of lead. As tin vessels are much used in cooking and other processes connected with food, this is a matter of very serious importance. Numerous examinations by eminent chemists have shown that milk pans, basins, dippers, cook¬ ing utensils, etc., are nearly all rendered dangerous by this means. The lead of tin-lined milk pans will not be affected to a sufficient ex¬ tent to do any harm until the milk sours, when the lead is rapidly taken up by the acids formed. Acid fruits of any kind, and even sweet fruits, sirups, and preserves, when cooked or allowed to stand for any length of time, may become contaminated with lead, and pro¬ duce lead poisoning. Tomatoes, vegetables, and various fruits put up in tin cans, may become contaminated in this way. This kind of tin may be detected by a simple test which any one can apply. Place upon the metal a drop of nitric acid, spreading it to the size of a dime. Dry over a gentle heat, apply a drop of water, and then add a small crystal of iodide of potash. If lead is present, a yellow color will make its appearance very quickly after the addition of the crystal of iodide of potash. The cheaper grades of tin are, almost without exception, adul¬ terated in this way. On this account, we should by all means dis- POISONING FROM FRUIT- JARS. 431 courage tlie use of tin cans for canning either fruit or vegetables, the danger of contamination being so great. For those who put up their own fruit, glass cans are fully as cheap, as they can be used many times instead of but once. Poisoning from Fruit- Jars. — Another danger to which atten¬ tion has been called very recently is from the use of glass fruit-cans with zinc covers. Only those having glass or porcelain-lined tops should be employed. The danger of using those with zinc covers is shown by the following account of a case of poisoning which wre quote from a prominent sanitary journal of recent date (1880) : — “Four persons were poisoned recently in Brooklyn from eating canned cherries. Fortunately they all recovered by prompt treat¬ ment. Prof. Geo. W. Plympton made an analysis of the fruit left, and found the poison to be a salt of zinc formed by the action of the acid in the cherries on the zinc cover of the jar. The preserving had been done with scrupulous care, the jars were of a kind in common use, and the contents of several had been eaten without any unpleasant effects. On examining some which had not been before opened, one having a zinc top with a porcelain lining was selected, and in it there was no indication of zinc. But on pouring a portion of the sirup of this jar into the zinc cover of the first, and warming it over a water- bath for three-quarters of an hour, the solution promptly yielded to the test for zinc. . . . The case is not without parallel, and the public should learn that the use of zinc or galvanized iron in the preservation of fruit or vegetables is not free from danger.” Lead Glazing. — Within the last few years there has appeared a kind of glazed ironware which is in the highest degree unsafe on ac¬ count of the amount of lead and even arsenic contained in the glazing. The quantity is so great that acid fruits would readily become af¬ fected. Crockery is also sometimes glazed with lead, making it dan¬ gerous to use except for dry substances. This ware may be tested in a manner similar to that suggested for lead-adulterated tin. Only the “ marbleized ironware ” is adulterated. “ Granite-ware” is safe. Accidental Poisoning of Water with Zinc and Lead. — By means of lead and zinc employed as water-pipes, tanks, eave-troughs, roofs, cistern covers, etc., water may be so charged with these mineral poisons as to become highly dangerous to health. Many cases of lead paralysis have been caused by taking lead in some unsuspected man¬ ner, such as mentioned. Hence it is very important that the public 432 FOOD AND DIET. should be told to be on the lookout for danger from this source. Nei¬ ther lead nor zinc is a suitable material for the conveyance or storage of water, and should never be employed. Galvanized iron is no bet¬ ter than zinc. When obliged to drink water which runs through lead or zinc pipes, it should be allowed to run some little time before being used, in order that that which has been long in the pipe may be ex¬ changed for that which is pure. Only pure tin should be used for roofing, eave-troughs, leaders, etc., when the water collected is to be used for drinking or cooking purposes. Wood and iron are much to be preferred to lead or lead-tin as a material to be used for such pur¬ poses. In cases in which tin containing lead has been used for roof¬ ing purposes, the difficulty may be remedied by covering the roof with a mixture of coal-tar and water-lime cement, in the proportion of one part of lime-water to three of coal-tar. Roofing tin is so rarely pure that it may be considered as being always contaminated with lead. Hence the importance of attending to the last suggestion made. W A TER: ITS HYGIENIC USES, AND DANGERS PROM ITS USE WHEN IMPURE. The Hygienic Value of Water. — If we except pure air, it may safely be said that no other element in nature sustains so important relations to the living system as does pure water. An individual will live much longer on water alone than if deprived of drink. Water constitutes a large proportion of all our food, varying, in grains and vegetables, from fifteen to more than ninety per cent. If the water thus contained in solid food were wholly removed, an individual would doubtless be enabled to subsist longer on water only than on solid food so treated. Though water undergoes no change in the body, and hence takes no part in the development of force, it is abso¬ lutely essential to the performance of the vital functions, being nec¬ essary to enable the various organs to perform their offices in the maintenance of the vital activities. The circulatory system is especially dependent upon this element. Water is the menstruum which floats the blood corpuscles and the varied nutritive and excrementitious elements which form the blood. By its aid, the nutrient particles destined to enter into the structure of the body are conveyed to the most minute and remote fibre of the intricate human mechanism where repair or growth is demanded. No other element in nature is so well suited to this exact purpose as water. It is so limpid and mobile that it can circulate through the most delicate capillaries, and can even find its way, by osmosis, into parts inaccessible by openings. Thirst. — Water is continually passing away from the body. The dry air entering the lungs by respiration absorbs it from the moist surface of the pulmonary membranes. A large portion is lost by evaporation from the skin, upon which it is poured out by millions of little sewers, the perspiratory ducts, for the purpose of washing away impurities from the system. The kidneys remove a consider¬ able quantitv, with poisonous excrementitious elements in solution. 98 433 434 HYGIENIC VALUE OF WATER. Through still other channels water is removed, aggregating, in all, the amount of five pints in twenty-four hours in the average individual. This loss must be made good, in order to preserve the requisite fluid¬ ity of the blood ; and nature expresses the demand for water by thirst. Some people rarely drink liquid of any kind. Others consume several pints in a day. The nature of an individual’s occupation will in a measure determine the amount of drink .required. Stokers, glass-blowers, and others whose vocation necessitates profuse perspi¬ ration, . equire more water than others. It will be noticed, moreover, that the character of the diet has much to do with the demand for drink. Those who subsist mostly upon fruits and grains, and other vegetable productions, avoiding the use of stimulating and irritating condiments, require little or no addition to the juices contained in their food. Those who pursue an opposite course in dietetics, using largely animal food, salt, pepper, spices, and other condiments, and perhaps drinking a little wine or something stronger, are under the neces¬ sity of taking considerable quantities of fluid in addition to that provided by their food. Water is the only substance which will quench thirst. Beverages which contain other substances are useful as drinks just in proportion to the amount of water which they contain, and are unwholesome just in proportion as the added elements are injurious. Regulation of Temperature. — The evaporation of water from the surface of the human body is one of the most admirable adapta¬ tions of means to ends exhibited in animal life. All of the vital ac¬ tivities in constant operation in the body occasion the production of heat. Sometimes the amount of heat is greater than is needed, and so great as would destroy the vitality of certain tissues if it were not speedily conducted away. By evaporation of water from the skin, this is accomplished. When external heat is great, perspiration is more active than when it is less, and thus the temperature of the body is maintained at about 100° F. under all circumstances. By this won¬ derful provision of nature, man is enabled to exist under the great extremes of heat and cold presented in the frigid regions at the poles and the torrid climate of the equator. By the aid of clothing, human beings have survived a continued temperature of C0° to 100° below zero ; and, by the protective influence of evaporation, an average of 100° above zero has been endured in tropical climes. For short peri¬ ods, so great a degree of heat as 350° F., or even 600° has been borne DEPURATION. 435 with impunity in exceptional instances. In these cases the extreme heat which would otherwise reduce the body to a cinder in a few moments is rapidly conducted away by evaporation without occasion¬ ing any damage. Depuration. — Every thought, every movement, the most delicate vital action, occasions the destruction of a portion of the living tissues, which is thus converted into dead matter, and becomes poisonous. Many kinds of poisonous substances are produced within the body in this way. Some of them are very deadly, and must be hurried out of the system with great rapidity, as urea and cholesterine. Here the marvelous utility of water is again displayed. It dissolves these poisons wherever it comes in contact with them, and then as it is brought by the current of the circulation to the proper organs — the kidneys, liver, skin, lungs, and other emunctories — it is expelled from the body, still holding in solution the animal poisons which are so rapidly fatal if retained. Prof. Liebig and others have shown that the free drinking of water greatly favors the elimination from the system of the products of waste in the system; It not only increases the quantity of fluid elim¬ inated by the skin, the kidneys, and the liver, but also the amount of solid matter. The free use of water also hastens tissue change, thus enabling a person by this means to rapidly change or renovate his tissues when such a change is desirable. Experiments have shown, further, that the free use of pure water as a drink encourages assimi¬ lation. It is well known that it is conducive to fatness. Thus it ap¬ pears that water is the chief of all alterative remedies which can be administered internally. It may be further mentioned that water is useful as an aid to di¬ gestion in dissolving the elements of food. It is also of very great value as a means of applying heat to or abstracting it from the body for remedial purposes, as well as for cleansing purposes, being the uni¬ versal detergent. The following table gives a correct idea of the relative importance of water as an element of the body, according to the results obtained by the best observers : — 43G THE USES OF WATER. PROPORTION OF WATER IN 1000 PARTS. The entire body, TOO Teeth, . 100 Bones, ........... 130 Cartilage, 550 Muscles, ........... 750 Ligaments, ........... 768 Brain, ........... 789 Blood, . 795 Synovial fluid, .......... 805 Bile, 880 Milk, . 887 Pancreatic juice, ......... 900 Urine, 936 Lymph, ........... 960 Gastric juice, .......... 975 Perspiration, .......... 986 Saliva, ............ 995 The proportion of water found in the most common articles of food may be seen by reference to the table (page 370) giving the constituents of various food substances. Composition of Water. — Chemically considered, water is made up of two gases, oxygen and hydrogen, in the proportion of one vol¬ ume of the first to two of the second, and by weight, of eight parts of the first to one of the second, as oxygen is sixteen times as heavy as hydrogen in equal volumes. Water contains in addition, in solu¬ tion, a certain proportion of atmospheric air, unless the air has been removed by some artificial process, or unless the water has been re¬ cently produced by distillation. It is this dissolved air which sup¬ ports the life of fish and other marine animals. A fish will die as quickly in water which has been boiled as if removed from the water entirely. Pure Water. — Chemically pure water is not found in nature. All natural water, whether taken from springs, wells, lakes, streams, dug wells, deep artesian wells, or caught as it descends from the clouds, contains a larger or smaller proportion of impuri¬ ties. As a general thing, rain-water contains fewest impurities when it is freshly collected upon clean surfaces. Its character de¬ pends, however, in a very great degree upon the locality where it is obtained, and the manner in which it is collected. In and near large HAUL) WATER. 437 cities, rain-water is always considerably colored and contaminated with smoke, dust, animalcules, portions of hair, etc. In the country, remote from populous districts, a much greater degree of purity is ob¬ tainable. The character of water obtained from lakes, streams, springs, or wells, in a large measure depends upon the character of the soil through which it passes, as nearly all substances found in the earth, even the hardest rocks, are in some degree soluble, so that water passing through the soil and various strata near the surface, dissolves and holds in solution a great variety of mineral elements. The chief of these are compounds of lime and magnesia. H ard ~W ater. h ater is said to be hard when it whl not produce a good lather with soap, but forms curds instead. Hardness is due to the presence of earthy salts in the water ; salts of lime — chalk and gypsum — are the most common. T wenty grains per gallon of any of these salts is sufficient to render water hard and unfit for use, though some waters furnished to cities for general use contain from 70 to 1G0 grains per gallon of solid matter. Hard water is unfit for cleansing purposes because its mineral ingredients form insoluble compounds with fatty substances. When mixed with soap, the lime or other mineral takes the place of the soda or potash in the soap, and forms an insoluble curd, instead of a lather. When a large quantity of soap is added, a lather can be formed, as the minerals in solution are neutralized by the extra amount of soap. Water which contains a pound of lime, or its equiva¬ lent of other minerals, in ten thousand gallons, is said to be of one de¬ gree of hardness ; that having two pounds of lime in the same quantity of water, two degrees of hardness, etc. Is Hard Water Wholesome ? — This question has been much dis¬ cussed by sanitarians and physiologists. Some have claimed that hard water is much more wholesome than soft, and even very important for the preservation of health and to secure proper physical development, while others have taken the opposite ground. The following are the principal arguments which have been urged in defense of hard water : — 1. Nature provides hard water, and hence it must be more natural to employ it than to use soft water artificially purified. 2. The body needs some of the salts held in solution by hard water, and is consequently deprived of them when soft water is used. 3. People who use hard water are more healthy than those who em¬ ploy soft. 4:38 THE USES OF WATER. 4. Hard water is less liable to become poisoned by passing through lead pipe. The first objection disappears when we consider the fact that with man drinking is a practice which is largely the result of other unnatu¬ ral habits and forced conditions. Comparative anatomy clearly proves that man is naturally frugivorous in dietetic character, his natural diet being mostly fruits, with a few of the most easily masticated grains. This being the case, it is evident that so far as the provisions or inten¬ tions of nature are concerned, the evident design was that man should obtain all the watery elements he requires from the juices of succulent fruits. That this may be done without inconvenience or failure of per¬ fect nutrition, has been again and again demonstrated by actual exper¬ iment. Indeed, persons who have discarded from their dietary, salt, pepper, spice, and all irritating substances of like nature, often find that they have no necessity whatever for drinking, and that weeks and months pass without the thought of drinking. In regard to the second objection, we may say that there is no evi¬ dence that water was ever intended as a medium for conveying to the body those elements of a mineral character which are thought to be necessary to the proper maintenance of the body. And, furthermore, there is no satisfactory evidence that the system can ever appropriate as nourishment any kind of mineral matter, either in solution or any other form ; but there are many facts which indicate very conclusively that the human system can only assimilate such substances as have been organized by the action of vegetable life and growth. On this point, an eminent surgeon, lecturing before his class in a celebrated Western med¬ ical college, remarked, “ The administration of mineral salts in the form of solution will occasion an increase of their quantity in the excretions of the body, but will not remedy any deficiency of this kind of material which may be supposed to exist in any portion of the system.” Again, the mineral matter found in hard water is of a character which would render it of little value to the system were it capable of assimilation, — judging from analysis of the bones, — since the principal constituent of bony tissue is phosphate of lime, while the chief ingredi¬ ent of hard water is carbonate of lime, a substance which is found in the bones only in small quantity, and which may be by no means essential. Nothing could be more uncandid and deceptive 'than the manner in which the statistics have been collected which seem to show that hard HARD WATER. 439 water is more conducive to health than soft water. The varying condi¬ tions of the inhabitants of the districts compared, as relates to other cir¬ cumstances which affect health, have been entirely ignored. Thus, the claim for the superior character of hard water is made when it is found that the inhabitants of elevated mountainous districts, where the ad¬ vantages of a pure and invigorating atmosphere, together with constant and vigorous exercise, are ever present, are more healthy, notwithstand¬ ing the use of hard water, than those who use soft water, living in low, malarious districts, or situations otherwise unfavorable to health. Or, again, a similar comparison is made between those who use hard spring water, free from organic impurities — as decaying vegetable and animal matter — and those who are compelled to use soft water which is filled with the many poisonous substances and compounds resulting from the decomposition of organic substances. Thus, it is found that the inhabitants of London, who use the imperfectly filtered water of the Thames River, into which is poured all the filth and offal of that great city, are much less healthful than the sturdy Highlanders of Scotland, who use hard water as it bubbles cool and pure from the springs of their native mountains. The fourth objection is hardly worthy of notice, though not infre¬ quently urged. It is true that hard water, in passing through lead pipes, after a time deposits a coating of lime upon the interior, thus pro¬ tecting the water from contamination by the lead ; but this advantage is by no means sufficient to render it advisable to adopt the use of hard water, since poisoning from lead pipes may be still more effectually pre¬ vented by a lining of glass, as is now done. The evils resulting from the use of hard water are numerous, and many of them exceedingly painful. Some of the most common are tor¬ pid liver, and biliary, renal, and urinary calculi. The best advice we can give those who cannot obtain from wells, water which is nearly soft, is that they should by all means resort to the use of rain-water, cleansing it from impurities by means of a filter. A home-made one may be easily constructed. See pp. 444-448. The idea that the lime, magnesia, iron, and other minerals found in water are beneficial to the human system is as absurd as that the car¬ bonic acid, ammonia, sulphureted hydrogen, and othbr noxious gases, poisonous germs, etc., found in the atmosphere, are necessary for the maintenance of animal life. A final and conclusive argument which shows the utter weakness of 440 THE USES OF WATER. the reasoning in favor of hard water is that the amount of “ salts ” con¬ sidered so important, which would ordinarily be received through the use of hard water, even if it should he appropriated, of the possibility of which there is good reason to doubt, would be so inconsiderable, compared with the amount received through other and better means, as to be ut¬ terly insignificant. For example, hard water which is considered suita¬ ble for use, even by those who advocate hard water, is not often of more than twenty-four or five degrees of hardness. This would supply about sixteen grains of salts per gallon of water. Few people take more than two and one-half pints of water a day in the form of drinks, which would afford only five or six grains of “ salts,” and that in an inorganic state. More than double this quantity would be supplied by an ounce of oatmeal, a half-ounce of meat, an ounce of peas or beans, or a gill of milk. When we consider that the average amount of food taken daily supplies the system with from thirty to one hundred times as much min¬ eral matter as would be received in drinking hard water, the argument that hard water is necessary to supply mineral elements to the system becomes ridiculously absurd. No directions are needed for the detection of hard water, as every one is familiar with its effect upon soap. Undoubtedly many will be pleased, however, to learn — . To Soften Hard Water. — V ery hard water is objectionable, not only on account of its injury to health, but on account of the great in¬ convenience and expense which it involves through the waste of soap and the increased labor in using it for washing. There are several means of rendering water soft, or nearly so, based upon the fact that lime and magnesia are very insoluble in water unless it contains an ex¬ cess of carbonic acid. Hard water may be softened by adding soap until the lime and magnesia are neutralized, and then as much more as is needed for washing ; but this is an expensive and troublesome mode. A better way is boiling for half an hour. This expels the carbonic acid and causes the lime to settle in a chalky deposit on the containing vessel. It is this which occasions the troublesome incrustations in steam boil¬ ers and the chalky deposits in tea-kettles used with hard water. A more commonly employed method is the use of washing-soda. The cheapest and best method* when large quantities of water are to be used is to em¬ ploy quicklime. For tolerably hard water, add one gallon of clear, freshly made lime-water to twenty gallons of the hard water, and allow it to settle twelve to twenty-four hours. A few experiments in testing Animalcules and Infusoria in Thames Water. Animalcules and Infusoria in Water. Plate XIII. ORGANIC IMPURITIES IN WATER. 441 the water after the addition of the lime-water will suffice to determine the amount to add to any particular water to secure the best results. It should be remarked that the hardness due to the presence of gyp¬ sum or sulphate of lime in the water cannot be remedied by the last method described. The only remedy is the use of washing-soda or carbon¬ ate of soda, or distillation. A water which produces a chalky deposit in the tea-kettle will be benefited by the lime process. Distilled water is, of course, almost absolutely pure, though it has a “ flat ” taste and is not agreeable on that account. This is owing to the absence of air. Air may be readily restored, however, by agitation, as by pouring the water repeatedly from one vessel to another, or by get¬ ting it into a finely divided state by means of a spray. Distillation is the method employed on many ships for obtaining drinkable water from sea-water. Organic Impurities in Water. — For years it has been known that water may be the means of conveying into the system poisons of the most serious character. It has been positively shown in hundreds of cases that typhoid fever may originate in this way, — most frequently does, in fact, — and there is reason for believing that diphtheria, dysen¬ tery, cholera, and other epidemic diseases, may be carried by means of water. The organic impurities of water are of two kinds : first, decompos¬ ing animal or vegetable matter ; and second, living animalcules and germs. Both of these forms of organic matter are in the highest de¬ gree dangerous to health. As the two kinds of impurities always ex¬ ist together, they may for the most part be considered together. The living creatures found in impure water are of numerous varieties, but are known by the general term animalcula. Excellent representations of some of these minute creatures are to be seen on Plate XIII. The sources of contamination of water are numerous. Wells, springs, and underground cisterns are very frequently contaminated by communication, either directly or indirectly, with a sewer or cess¬ pool, or by the drainage from a barn-yard or a privy vault. Thousands of cases of typhoid fever have been traced directly to the use of water thus contaminated. Wells, cesspools, privy vaults, and cisterns are often located so near each other that communication is exceedingly easy, through the porous earth, and the contents of one become min¬ gled with those of the other. The well, being deeper than either cess¬ pools or vaults, becomes a drain for these receptacles of filth. C areful 442 THE USES OF WATER. experiments have shown that the area a well will drain in a porous soil is in proportion to its depth, the diameter of the circle drained in¬ creasing six feet with each foot of depth. Thus a well ten feet deep would drain a circle sixty feet in diameter, and any cesspool or privy vault, manure heap, or other collection of decaying matter within thirty feet of the well, would he almost certain to discharge more or less of its foul matters into the well. How well-water may be con¬ taminated in this way is clearly shown in Plate XV. Twelve cases of typhoid fever occurred among persons using water from a well located as represented in Fig. 2 of the plate. When the surface of the ground or of the underlying rock is sloping, the danger is greatly increased. Wells also often become contaminated by means of the death and decay of worms, bugs, and small animals which fall into them and are not removed by frequent cleaning. We were acquainted with one instance in which the water became so bad that it was believed that “ a mineral spring had broken into it.” The prospect of discovering such an anomaly led to a critical chemical examination of the water, and an inspection, which revealed the fact that sundry dead cats, toads, rats, cast-off shoes, garments, and other decomposable substances, had been deposited in the well and imparted to the water its mineral¬ spring flavor. Wells and cisterns should be often cleaned, and should be located at least ten rods away from any cesspool, vault, barn -yard, garbage heap, or other possible source of contamination, and should be so protected above that vermin and small animals cannot get in. How to Detect Bad Water. — It is very important that every per¬ son should be familiar with the simple methods for determining with tolerable certainty and accuracy the character of water liable to be used for drinking and cooking purposes. The following methods are reliable : — The Fermentation Test. — Put some of the water to be tested in a small bottle, and add a pinch of pure white sugar. Place it un¬ corked in a warm place. If cloudiness appears within two days, the water is too impure to be used with safety. Care must be taken to have the bottle perfectly clean. The cloudiness can be most easily discovered by holding the bottle up against a dark or black ground, in a good light. Permanganate-of-Potash Test.— The following is the best form of this useful test, which is the most reliable of any simple method of ex¬ amining water for organic impurities : — IMPURE ICE. 443 Dissolve in an ounce of water twelve grains of caustic potash and three grains of permanganate-of-potash crystals. Keep in a glass-stop¬ pered bottle. Add a drop or two of this solution to a gill of the water to be examined, placed in a perfectly clean and clear bottle. The per¬ manganate solution has a beautiful pink or purple color. If this is changed to brown or disappears after standing a few hours, the water is impure and unfit for use. The permanganate alone is found to be unreliable, as it sometimes fails to detect the presence of some kinds of organic poisons. Suspended Impurities. — Water is often turbid from the suspen¬ sion in it of substances which are merely mechanical impurities, the water becoming entirely pure after the removal of the same. The water of the Mississippi, otherwise considered remarkably pure, is very turbid or roily. The same is true of the water which is supplied to many of our large cities, at some seasons of the year, when the streams which furnish the supply are swollen by recent rains. Impurities of this sort can be best detected by holding a clear goblet containing the water against a dark background in a good light. It is important, also, to observe the odor and color of water. The odor is best detected by shaking a quantity in a wide-mouthed bottle, half filled, and placing the nose to the mouth of the bottle. If no odor is detected, the liquid should be heated and examined again. The addi¬ tion of a little caustic potash will sometimes bring out a bad smell not otherwise apparent. Impure Ice. — Great quantities of ice are used in all parts of the United States, probably more than in any other country. Hence, it is of importance that ice, the solid form of water, should be pure as well as the liquid form of the article. There is a popular notion that water “ freezes pure,” which is in some degree true, but not to the extent com¬ monly believed. If the lake or pond from which the water is taken is very impure, the ice will be likely to retain an injurious quantity of the same impurities. Animalcules and low forms of vegetable life which appear in lakes and ponds, usually exist in largest numbers at or near the surface. Decomposing organic matter also usually floats upon the surface. These pernicious substances may be entangled in ice, which may thus become a source of serious disease. Low forms of life readily withstand a temperature much below the freezing point of water, so that as soon as the ice thaws they become active agents in producing disease. We have often seen ice which gave forth a very unpleasant 444 THE USES OF WATER. odor while melting, and gave to the water in which it was placed a dis¬ agreeable flavor. In the summer of 1875, a serious outbreak of sickness occurred at Rye Beach, a sea-side watering-place in New Hampshire, which was traced to the use of ice taken from a stagnant pond in which was a large quantity of decomposing sawdust. Hr. Austin Flint, of New York City, had occasion some time since to investigate the probable origin of several cases of typhoid fever, and was unable to trace the disease to any other source than ice. “ Great quantities of ice are taken from canals, from creeks, from stagnant ponds, and from streams that are either the natural or the artifi¬ cial recipients of surface drainage, of the outpourings of sewers, and of un¬ cleanliness from various sources,” and it is not at all improbable that it may be a vehicle for typhoid infection. It is important to notice that “ the danger from ice taken from im¬ proper places is not only from that which is drank, but from its use in refrigerators and preservatories, where milk, butter, fruits, vegetables, and meats are subjected to its saturating influence as it vaporizes.” All would do well to look sharply to this possible source of disease and death. Find out the source of the ice which is purchased, and if there is a possibility of its being contaminated, reject. It will be better to do without ice altogether than to run any risk of contamination. Ice should never be gathered from stagnant water, nor from streams which are contaminated by sewage. No doubt many cases of illness arise from this source without being suspected, and possibly many deaths occur without the true cause being discovered. The Purification of Water . — As impure water is so abundant, and pure natural water often so limited, it is important that simple and efficient means for the purification of water be generally understood and adopted. Some waters are so impure that no attempt to render them wholesome can be successful, at least sufficiently so to render their use safe or justifiable. Water which contains considerable quantities of sulphate of lime or magnesia, mineral waters, and water which is badly contaminated with sewage, or the drainage from cesspools, vaults, or barn-yards, are of this class. To Remove Turbidity. — The fine particles often suspended in water obtained from rivers are usually of the nature of fine sand or finely divided clay. The greater share of the suspended particles will be de¬ posited as sediment if the water is allowed to settle for a day or two. REMOVAL OF ORGANIC MATTER. 445 A quicker way of clearing such water is to add to it a small quantity of alum, decoction of logwood chips, or the white of egg, stirring well and then allowing it to settle for a few hours. To Remove Organic Matter, Color, and Foul Gases. — Organic matter is by far the most serious impurity usually found in potable waters, and upon its entire removal, more than upon anything else, de¬ pends the success of any method of purification. The methods described for removing turbidity will also in some measure remove the impurities mentioned in this paragraph, but by no means thoroughly. Boiling ac¬ complishes much more, by expelling the gases and destroying the poi¬ sonous properties of the organic matter, and to some degree precipitating it. A solution of permanganate of potash may be used for the same purpose, a strong solution being added to the water contained in a con¬ venient vessel and stirred thoroughly. The solution should be added drop by drop so long as its color changes in the water from a faint pink to a brown or yellowish color. Examinations may be made from time to time by placing a clear white glass goblet full of the water under¬ going purification, in the middle of a sheet of white paper, and placing beside it a goblet of pure water faintly tinted with the permanganate solution, and viewing the two solutions in a clear light. As soon as a pinkish color begins to appear in the water, it should be allowed to stand an hour or two, after which it should be examined again, and the operation repeated, if necessary, until the pink color remains permanent. Filtration. — The methods above described are, of course, only adapted to waters which contain but a very small proportion of organic or suspended matters. The only really efficient mode of purifying water, at least on any but a very small scale, is filtration. There are various forms of filters, of different degrees of efficiency. The chief fil¬ tering mediums are sand, spongy iron, and charcoal. Sand removes only the suspended matters. Spongy iron removes a small proportion of the organic matter, but impairs the water by impregnating it with iron. Charcoal removes the suspended matters, a great share of the organic matters, and animalcules and other low forms of life. Vegetable char¬ coal is very efficient, but animal charcoal is much more so. The fil¬ tering medium is employed either loosely packed or made into solid blocks or slabs. The water is filtered by being made to pass either downward or upward through the filtering material, the upward method being generally considered the most desirable, as filters constructed on 446 TEE USES OF WATER. this plan will last longer than those in which by the constant down¬ ward action the water becomes foul sooner with suspended impurities. The superior purifying power of charcoal is due to the oxygen which it contains, condensed in its pores in very active form, by which the organic elements are oxi¬ dized, or burned up, and thus rendered harmless. Charcoal possesses the property of con¬ densing in its pores a large amount of oxygen, the amount varying with each variety of charcoal, according to the fine¬ ness of the grain of the wood from which it is made. The hardest, finest-grained woods make the best charcoal. As Fig:. 169. A Reservoir Filter. . . , charcoal deteriorates with age, it should be newly burned when used for filters. Care of Filters.— The ma¬ jority of people who purchase Fig1. 170. Same as Fie. 163, but showing Filter in , Section. filters pay no attention to the directions for use which gener¬ ally accompany them, and which must be attended to scrupulously or the filter will become a means of contamination instead of purification. The first thins; essential in the care of a filter— and this is not often in- O Some of the most common and efficient forms of filters are represented in Figs. 169 to 173. From the descriptions given, almost any one can con¬ struct, or hire made for a small sum, a really efficient filter. sisted upon by manufacturers — is that it should be allowed to become dry every day, or at least once in two or three days, being allowed to remain thus for an hour or two so that the charcoal may have an oppor¬ tunity to absorb fresh oxygen from the air to enable it to continue its purifying process. The oxygen contained in the charcoal when placed in the filter is soon consumed, and, unless often renewed, the filter will CARE OF FILTERS. 447 become worthless ; and from the accumulation of organic matter may become a breeding-place for germs. We have seen filters which in consequence of this neglect had become so foul within a few weeks that water which was comparatively pure, after being passed through it was found to contain large numbers of animalcules, and organic matter in large quantity, and had an odor highly suggestive of de¬ cayed eggs. Fig. 171. Simple Form of Filter, for household use. a. Water-pan, or reservoir; 6. Sponge; c. Jug to re¬ ceive filtered water; d. Gravel; e. Charcoal ; /. Faucet. rig-, 172. A Filter made after plan shown in the preceding cut. Fig1. 173. Pock¬ et Filter, arranged to use as a Siphon. In order to be safe and efficient, a filter requires cleansing every few weeks or months, according to the amount of water filtered, and its quality. When ordinary cistern water is used, a filter should not be used longer than six months without cleansing, and if a large amount of water is used, not more than half that time. The sponge should be cleansed and scalded at least two or three times a week. The charcoal should be renewed every time a filter is cleansed. Fresh charcoal may be used or the old may be renewed by heating to red¬ ness in a close vessel, excluding air. The gravel and sand and the inside of the filter vessel, reservoir for filtered and unfiltered water, should be thoroughly cleansed when¬ ever the filter is taken apart for cleansing. The surest way to secure thorough cleansing is to boil the gravel and sand in a large kettle or wash-boiler for half an hour, rinsing out the filtering vessels with boil¬ ing water. After rinsing all well with clean water, wash everything with a strong solution of permanganate of potash and caustic potash. 448 THE USES OF WATER. A solution of one ounce of the permanganate and four of crude caus¬ tic potash in a pailful of water will be sufficient for an ordinary filter. If the permanganate solution becomes brown by the washing, more must be used, until a pinkish color remains when the gravel is rinsed. This will indicate that all impurities are removed. A few gallons of water will suffice to rinse away the remains of the permanganate, and the filter may be repacked as before, with fresh charcoal as directed. The closer the filtering medium is packed, the slower the water will filter through, but the more perfect will be the purification. rig. 174. Cistern filter, a. Receiving reservoir; b. Filtering medium, charcoal and gravel; c. Perforated slab ; <1. Rain-pipe; e. Overflow;/. Water-pipe leading to cistern ; g. Cistern. Cistern filters, as usually constructed, are not to be recommended, as they soon become clogged when placed in the cistern, and not be¬ ing readily accessible are not easily cleaned, so that they become sources of impurity instead of serving the purpose designed. It is possible, however, to connect a filter with a cistern in such a manner as to serve a very useful purpose in freeing water at least from the grosser impurities which are likely to be washed from roofs by rain. Fig. 174 shows the plan of filters which we had constructed for use in connection with two large underground cisterns at the Sanitarium, Battle Creek, Mich., which operate very satisfactorily. They require cleanin''’ about once in six months. o The Best Water. — The purest water is always the best. Soft water is far superior to hard, though hard water free from organic mat¬ ter is much to be preferred to soft water contaminated with organic impurities. In hard-water districts the use of filtered rain-water DANGERS FROM WATER CONTAMINATION. 449 should be generally adopted. By making proper provision for storage, almost any house affords roof surface sufficient to supply the family living in it with an abundance of the softest water. The average an- nual rain-fall between the thirtieth and fiftieth degrees of latitude is about forty-five inches. With this amount of rain, a roof affording four hundred square feet of surface would collect sufficient water to supply more than one barrel a day during the entire year, if none were wasted. It is best to have two or three cisterns, not only to supply sufficient storage capacity, but to allow opportunity for emptying one so as to clean it thoroughly as often as once in four or six months. Unless made of stone, cisterns should be bricked up from the bottom with good hard brick, and arched over. It is also best to cover the brick inside with a thick layer of Portland Cement. When tanks are used, the best material is iron, coated on the inside with coal-tar or some other impervious and insoluble covering. Cesspools, water-closets, and sewers should never on any account be connected with tanks from which water is used for drinking purposes. Numerous cases of serious and even fatal illness have resulted from neglect of the observance of this precaution, as water has the property of absorbing foul gases to a considerable extent. On the same ac¬ count, water should not be stored in the vicinity of anything giving out an offensive odor. Nothing could be more offensive to good taste and to sanitary principles than the custom of placing the water-tank of railroad cars in the water-closet. The offensive practice ought to be frowned down. It is by its property of absorbing foul gases that water becomes so unwholesome by standing in a sick-room, or over night in a sleeping-room. It is essential that all of these particulars should be well looked after in order that water may be to the body only a blessing, and not a curse, as it becomes when the laws to which attention has been called are violated. Mention has been made on pages 441 and 442 of the great danger of contamination of water, especially the water in wells, by the drainage from privy vaults. The enormity of this evil is by no means appieci- ated as it should be. An eminent sanitarian asserted not long since that a very large share of the wells of New England are so situated as to be in danger of contamination with excrement through the drainage from vaults. When a vault is used year after year without cleansing, the soil becomes saturated to a distance of many feet, especially when of a por- 29 450 THE USES OF WATER. ous nature. If a well is located within the area of saturation, as shown on Plate XVI, it will certainly be contaminated. Under such circum¬ stances a well becomes a drainage pit for the filth-impregnated soil, and with every rain great quantities of soluble excreta, and, in many cases, germs of disease, are washed down into the well. The only proper rem¬ edy for this danger, as it is often impossible to get sufficiently far away to escape danger, is to abolish vaults altogether; but as this cannot al¬ ways be done, the next best thing is to cleanse them frequently. This can be best done by means of the “ Ames Eagle Odorless Excavating Apparatus,” of which the accompanying cut is a good representation. Fig-. 174. The Ames Eagle Odorless Excavating Apparatus. Tli is apparatus has taken the precedence over every other of the kind wherever it has been introduced. Being personally acquainted with the president of the companv that manufactures this apparatus, we are sure that it is all that is rec¬ ommended, and we heartily wish that it may be introduced into every town and city in the United States. STIMULANTS AND NARCOTICS. This subject is generally considered under the head of “Food and Diet ; ” but from our firm conviction that such a consideration is an im¬ proper one on account of the wide difference between the substances in¬ cluded in this class and those which may be properly called food, we have chosen to consider them in a separate chapter. The history of narcotics and stimulants is one of the most interesting and curious of all subjects connected with the study of the manners, customs, habits, and characters of ancient and modern nations. Not¬ withstanding the generally admitted injury resulting from the use of stimulants and narcotics, it is an indisputable fact that every nation, tribe, and people, whether civilized, semi- civilized, or barbarous, almost without exception, makes use, more or less extensively, of some narcotic or stimulant. This fact has been mistaken by some as an argument in favor of the use of these drugs ; but, as we shall show, the opposite in¬ ference is the correct one. Before passing to consider the specific inju¬ rious effects of these almost universally used poisons, wo will take a brief glance at the various forms in which alcohol and other stimulants and. narcotics are employed in different parts of the world. Alcoholic Beverages. — Alcohol is a chemical compound resulting from the fermentation or decay of vegetable or animal substances con¬ taining starch or sugar. It never occurs in nature except as the result of fermentation. All fermented liquors used for intoxicating or stimula¬ ting purposes, owe their specific qualities wholly to the presence of alco¬ hol, unless, as is frequently the case, they contain accidental impurities or substances added by adulteration which possess similar properties. The following is a brief account, with the names, of the principal alcoholic liquors used by various nations, and the mode of producing them :■ — Wine is the fermented juice of the grape. Wines vary greatly in strength, according to the amount of sugar contained in the grapes from which they are produced. The stronger wines are “ fortified ” by the addition of pure alcohol. The weak wines contain seven to ten per cent of alcohol, and the strong fifteen to twenty per cent. 451 452 STIMULANTS AND NARCOTICS. Beer is the fermented liquid obtained from macerating in water barley which has been allowed to sprout sufficiently to convert the starch of the grain into sugar, and then roasted. Ale, stout, lager, and porter are different varieties of beer. Hops are usually added to beer to give a bitter flavor and to delay fermentation. The amount of alcohol con¬ tained in beer varies from one to three per cent in home-made or small beer to ten or twenty per cent in ales. Cider is the fermented juice of the apple. It is sometimes dis¬ tinguished as sweet cider when freshly made, and hard cider after having begun to work. The juice of apples, as well as of all other fruits, be¬ gins to ferment so soon after extraction from the fruit that it is not o often found in an unfermented condition, unless taken directly from the press. Perry is the fermented j uice of the pear. Alcohol, and various strong liquors, are obtained by distillation from some of the weaker fermented liquids. The art of distillation is said to have been discovered in the seventeenth century, though it is claimed that the Chinese have been familiar with the process for ages. What is termed proof -spirit, obtained in this way, contains fifty per cent of alco¬ hol. Strong alcohol contains ninety-five per cent. Absolute alcohol is obtained with difficulty, and can be kept only by complete isolation from air, so powerful is its affinity for water. Gin is said to be obtained by distilling fermented corn with j uniper berries ; but is really made by distilling any sort of crude, impure spirits with turpentine, carbolic acid, or creosote, and some other unimportant substances. It contains forty-eight to fifty-six per cent of alcohol. Whisky is obtained by distilling fermented grain or potatoes. It is made from almost any vegetable substance containing starch. Rum is made by distilling the refuse from the manufacture of sugar and molasses. Brandy is said to be obtained from the distillation of the fermented juice of grapes. The juice of any other fruit may be employed in the same way. Thus we have peach brandy. A large share of the brandy is simply whisky, colored and flavored. The above-mentioned alcoholic drinks are used more or less in all civilized countries and in many semi-civilized and even barbarous por¬ tions of the globe to which they have been carried by men eager for gain. In addition, many nations have peculiar drinks which they had made and used for ages before they had any communication with the civilized portions of the world. TOBACCO, TEA AND COFFEE. 453 Pulque is the fermented juice of a species of cactus which grows in Mexico and Central America. It is the favorite drink in those parts, and is freely indulged in. Chica is a liquor made by the natives of South America in a most peculiar manner, from corn. In the evening the family gather around a heap of shelled corn deposited in the center of the humble hut in which the natives of that country usually live. Beside the heap of corn is placed a large gourd vessel. Each one takes a handful of corn, places it in his mouth, and chews vigorously until it is well masticated, when he spits it out into the vessel and takes another mouthful. All continue this process until the whole pile is chewed, when the contents of the ves¬ sel are set aside or buried in the earth. Fermentation takes place very soon, and an intoxicating liquor is produced. The chewing process is. really useful, since it not only liberates the contents of the kernels of corn but converts some of the starch into sugar, which readily under¬ goes fermentation. The natives of some of the Pacific Islands make an intoxicating liquor in a similar manner. Palm-wine, or todcly, is made by the natives of warm countries where this tree is indigenous, by the fermentation of its sweet juices. A similar beverage is made by the fermentation of the juice of sugar¬ cane. Milk-beer, or koumiss, is made by the Tartars by the fermentation of the milk of mares. A very intoxicating liquor called arraca, or milk- brandy, is made by distilling koumiss. Arrack is a fermented liquor made from rice in rice-producing countries. Narcotics. — The number of narcotic or stupefying substances em¬ ployed in different parts of the world is fully equal to that of the al¬ coholic beverages used. We can mention but a few of the many dif¬ ferent substances employed. Tobacco. — This, the most widely used of all narcotics, is supposed to be employed by not less than 900,000,000 of the 1,400,000,000 inhab¬ itants of the globe. In India, Siam, Burmab, and China, the use of to¬ bacco is nearly universal among all classes of both sexes. The Turks are almost perpetual smokers. Opium. — This drug is said to be used by not less than 400,000,000 people. It is used most freely by the inhabitants of Eastern countries. Tea, Coffee, Cocoa, and Chocolate. — These four narcotics, essen¬ tially alike in character and effects, though obtained from widely differ- 454 STIMULANTS AND NARCOTICS. ent sources, are very largely used in all civilized as well as barbarous countries. Mate, or Paraguay tea, is the leaves of a South American tree, the properties of which are essentially the same in character as those of China tea. Indian hemp, or hashish, is a narcotic largely used by the inhab¬ itants of Persia, and in all Mohammedan countries. It is said to have the peculiar property of producing wonderful and pleasing visions, from which the devotee of the drug reluctantly awakens. It sometimes pro¬ duces the most violent delirium and a homicidal propensity. Lettuce. — The general opinion that the ordinary garden lettuce is a narcotic plant is shown to be true by chemical examination of the plant and experiments with it. The milky juice which exudes when the stem is cut contains a narcotic principle known as lactucarium. The free use of the leaves causes sleepiness, as many persons have experienced after eating heartily of lettuce salad. On this account the use of the plant is not to be recommended. It is not well to take food and med¬ icine together. Hops are also well known to be narcotic in their effects, which has led to the use of hop pillows to induce sleepiness, and hop poultices to relieve pain. Their narcotic properties are due to the active principle lupuline which they contain. The drowsiness resulting from the use of beer is due to the presence of this principle. The Betel-nut, the seed of a species of palm grown in India, Mala¬ bar, and Ceylon, is used by about 100,000,000 people, being chewed like tobacco. It is probable that larger quantities of this drug are used than of any other narcotic excepting tobacco, it being estimated that not less than 500,000,000 pounds’ weight are consumed annually. Its devotees are as abject slaves to its use when once addicted as are the users of to¬ bacco or opium to their favorite narcotic. Cocculus Indicus and Sweet Gale are narcotic drugs used in the adulteration of liquors. They are very powerful in their effects, pro¬ ducing an intense degree of intoxication, particularly the first named. The second is used in Scotland. In Siberia a fungus resembling the mushroom of this country is chewed for its narcotic effects, which are very marked, producing in¬ tense intoxication. Stramonium, derived from the thorn-apple, is employed by some tribes of South American Indians in the form of a narcotic drink. It sometimes produces the most extreme and even violent excitement. NARCOTICS. 455 Absinthe is a narcotic and intoxicating- drink consisting of an in- fusion of the leaves of wormwood in alcohol. It is much used by the French, and to its enervating effects, both mental and physical, has been attributed the incapacity of the French soldiers when compared with their German combatants in the F ran co-Prussian war. Emetic holly is a narcotic which is used by the Indians of Florida. The leaves are made into an infusion, and the decoction, known as “ black drink,” is largely drank by the chiefs, especially when about to engage in a council, much as many other tribes of Indians smoke to¬ bacco under similar circumstances. Among other intoxicating beverages used by different nations may be mentioned said, samshoo, and sacio , all of which are made from rice, and are used by the Greeks, Chinese, and J apanese, respectively ; kawa, a drink made from the macro-piper, or long-pepper, and used by the Pa¬ cific Islanders; bodki, made from the potato, used by the Russians and Poles; and tall ah, made from millet, and used by the Abyssinians. One very noticeable fact is worthy of attention in this connection; viz., that the various stimulants and narcotics mentioned, while very unlike in many of their properties, and differing in their effects, are all alike in that each contains some special poison which may be sepa¬ rated, and when taken pure, will produce serious and even fatal results- Some of these poisons, as morphia and nicotine, in a pure state are ex¬ tremely poisonous, being fatal in very minute doses. Others, as alcohol, caffeine, and theine, are equally fatal in somewhat larger doses. Having noticed very briefly the most commonly used stimulants and narcotics of many different nations, we shall now notice more par¬ ticularly a few of the more important ones, including alcohol, tea, coffee, tobacco, and opium, as these are the drugs most commonly used for stimulant or narcotic effects in this and all other civilized countries. 456 STIMULANTS AND NARCOTICS. EVIL EFFECTS OF ALCOHOL. The agitation of the temperance question during the last fifty years has had the effect to provoke a thorough investigation of the nature and effects of alcohol, and its relations to animal life, which has resulted in the determination of certain facts in relation to this subject which may be said to be demonstrated so far as it is possible for anything to be con¬ clusively settled by scientific investigations relating to the human sys¬ tem. One of the most active and efficient workers in this field has been Dr. B. W. Richardson, of London, Eng., who has long stood in the fore¬ most rank of scientific physicians the world over. The late Dr. Parkes, the eminent English sanitarian, and Dr. Edward Smith, also recently deceased, the author of some of the most scientifically accurate works on diet extant, have also done much in this field, as well as many French and German investigators. We shall endeavor to present to our read¬ ers the results attained by these laborious investigations as simply and concisely as possible. The results determined are decisive, and admit of no ambiguous interpretation ; and they should be treated and accepted with the respect and consideration due to scientific facts. Effects of Alcohol Definite and Constant. — The relation of al¬ cohol to living tissues, whether animal or vegetable, is always the same under the same circumstances. It is a poison, not only to man, but to lower animals and to vegetables as well. A leech thrown into alcohol dies in a few seconds. Plants whose roots are bathed in alcohol, even when very much diluted, not more than one part in a thousand of water, are retarded in their growth, become sickly and die. It is a drug which is in the highest degree inimical to the whole animated creation. Every form of life is destroyed by it. It is in man, how¬ ever, that its worst effects are seen. This is in one sense fortunate, for, as a brilliant writer wittily says, if lower animals were addicted to the drug in one-tenth the degree man is, in a short time there would not remain upon the face of the earth an animal which would be tamable, workable, or eatable. In whatever way alcohol is introduced into the body, whether through the stomach, through the skin, or through the lungs in the form of vapor, the effects are essentially the same. ALCOHOL IS A NARCOTIC. 457 Neither does it make a very great difference what form of alco¬ holic drink is taken, provided the same amount of actual alcohol is im¬ bibed. From the strongest rum down to hard cider and small beer the effects are those of alcohol. Alcohol ail Irritant. — Apply to the skin a small compress satu¬ rated with pure alcohol, covering it with oiled silk to prevent evapora¬ tion ; in a few minutes the skin will be reddened and irritated as though a mustard plaster had been applied. Take into the mouth a tablespoonful of alcohol. After holding it a few minutes the whole mucous membrane will seem blistered and benumbed. Alcohol a Narcotic. — The definition of a stimulant is that “which produces an increase of vital activity” [Webster]. According to the popular belief, not only among the common people, but among physicians as well, alcohol is an agent which will accomplish this ; but in the light of recent investigations the popular belief is not the cor¬ rect one. Alcohol decreases vital action, rather than increases it, and therefore cannot be a stimulant, except when it acts as an irritant by contact with delicate tissues. The best medical authorities now acree that this drug is a most powerful narcotic. It deadens the sensibility of the nerves, like ether, chloroform, and nitrous oxide. Chloroform and ether are both compounds which are made from alcohol. Half an ounce of alcohol held in the mouth a few minutes will so deaden the nerves of taste that they can appreciate no difference between salt and sugar, between sour and bitter. When alcohol is taken into the blood, it produces a similar condition in the brain and all the great nerve centers. Says Hr. E. Smith, F. R. S., of alcohol, “ I hold that its action, in all doses, is always that of a narcotic and paralyzer.” Says the eminent Dr. Richardson, “ I cannot by any argument yet presented to me admit the alcohols by any sign that should distinguish them from other chemical substances of the paralyzing, narcotic class.” Alcohol Destroys the Blood. — When this fiery drug is taken into the stomach, it is soon absorbed into the circulation, where it comes in contact with the corpuscles of the blood The effect upon these delicate and important structures we can study by applying al¬ cohol to the blood outside of the body ; for the corpuscles will retain their life and activity for several weeks after being removed from the 458 STIMULANTS AND NARCOTICS. body, if placed under proper conditions. To make sure of no mistake about this matter, we will perform the experiment while we write. Our microscope, which will magnify one million times, being in readiness, we thrust a needle into a finger and thus obtain a tiny drop of blood. Placing it upon a glass slide, we adjust it upon the instrument and look at it. Although the film of blood in view is so thin as to be transparent, it is crowded with beautiful bi-concave discs, the red blood corpuscles, each of which is perfectly formed, though only 1-3500 of an inch in diameter. Now we apply a drop of alcohol, a very tiny drop ; mark the effect. No sooner does it touch these little bodies than they begin to shrink, and soon lose all resemblance to their natural appearance. In a short time they are seen to be break¬ ing up into fragments ; and in five minutes from the commencement of the experiment the once beautiful and symmetrical little bodies which compose one-half of the blood, are reduced to broken fragments and shapeless masses. They have been fairly cut in pieces and eaten up by the alcohol. The contact of aicohol with the corpuscles also causes them to lose their coloring matter, a very important part, as it is by means of this that they are enabled to perform their work as oxygen carriers. This effect may be observed in those which give no other evidence of injury from the alcohol. “ But what harm does this do ? ” says the drunkard or the moder¬ ate drinker ; “ the loss of a few blood corpuscles cannot be of any great consequence.” The ultimate effect is the same as though the supply of air was cut off from the lungs by a cord tightly drawn around the neck. The business of the red corpuscles is to carry oxygen from the lungs to the tissues. If they are destroyed, oxygen cannot be carried in sufficient quantity, and the blood becomes foul, being charged with large quantities of carbonic acid, the poisonous substance which ought to be replaced by oxygen. One of the quickest known ways of de¬ stroying life is to cause an animal to inhale a poisonous gas known as carbonous oxide, which has the effect to paralyze all the blood corpus¬ cles. Alcohol does the same thing just in proportion to the quantity taken. In addition to its effects upon the corpuscles, alcohol produces other serious changes. One of the most important of these is coagulation or thickening of the fibrine of the blood, which occasions the formation of little clots which are swept along in the blood current until they reach 0 0 0 O 0. © Plate XIV.— EFFECTS OF ALCOHOL AND TOBACCO. A. Healthy stomach. B. Congested stomach of moderate drinker. C. Ulcerated stomach of habitual drunkard. D. Stomach in delirium tremens. E. a Healthy blood : b. Blood of tobacco- user; c. Blood of drunkard. F a. b. Fatty nerve fibres of drunkard ; c. d. Fatty muscle fibres of drnnkard. G. Section of fatty liver of drunkard, magnified. EFFECTS OF ALCOHOL ON THE HEART. 450 the finest capillaries, where they are lodged, thus obstructing the circula¬ tion, and, according to the eminent Prof. Carpenter of England, consti¬ tuting the first beginning of organic disease of the nerve centers and other important organs. These minute clots often constitute the cause of boils and troublesome abscesses; and when they become large, as they some¬ times do, they may produce instant death by the plugging up of a large artery in the brain, an accident which, there is every reason to be¬ lieve, is not uncommon in cases in which large quantities of alcoholic spirits are taken. Alcohol also greatly increases the amount of fat in the blood, probably by preventing the changes necessary to the complete digestion or assim¬ ilation of fat. There is also reason for believing that alcohol has a paralyzing effect upon the white blood corpuscles, interfering with them in such a manner as to prevent their passing out through the walls of the vessels in their usual manner. ]t may be further objected that these changes do not occur unless very large quantities of alcohol are used. This, again, is an error. Dr. Carpenter is authority for the assertion that the changes in the corpus¬ cles and in the fibrine of the blood take place when not more than one part of alcohol to five hundred of blood is employed. Thus it will be seen that the very weakest wines are unsafe, since none of them contain less than three to five per cent. Even small beer would be capable of doing mischief in this way. The weakest wines would need to be di¬ luted with four times as much water, in order to prevent the injurious results described. The effects of alcohol upon the blood may be clearly seen by refer¬ ence to Plate XIV. Effects of Alcohol Oil the Heart. — When alcohol is taken into the blood, it soon comes in contact with the nerve centers which govern the action of the heart. Its effect is the same as upon the other nerve centers. It paralyzes them, just as chloroform does the brain. Then the heart is like a steam engine without a governor, or a clock from which the pendulum weight has been removed. It runs down with wonderful rapidity. This effect is largely due, also, to the influence of alcohol upon the small blood-vessels, the nerves which control them becoming paralyzed, they become dilated or relaxed, and so afford less resistance to the action of the heart, allowing it to beat too rapidly. This increased action is most unfortunately mistaken for increase of 460 STIMULANTS AND NARCOTICS. strength on the part of the organ, when it is mere increase of action^ wasted force. The amount of extra work (lone by the heart under the influence of liquor may be readily estimated. Dr. Parkes, by a series of careful experiments, found that the pulse of a man whose heart beat about 74 times a minute, or 106,000 times in twenty -four hours, when drinking only water, was, when under the influence of one ounce of alcohol per day, compelled to beat 430 times more in a day. Two ounces of alcohol per day caused an increase of 1,872 beats a day. Four ounces required 12,960 extra beats. Six ounces drove the pulse up to 18,432 extra beats; and eight ounces to 25,488 un¬ necessary beats, or nearly one-quarter more than when taking only water. The results of this experiment are of great value. They show very clearly how alcohol wastes not only the force of the heart, but of the whole body. The force exerted by the heart at each beat has been variously estimated at from five to fifty pounds. Assuming ten pounds as the actual amount of force expended, we may readily ascer¬ tain the amount of force wasted through the increased action of the heart by different quantities of alcohol. Thus, one ounce of alcohol, with 430 extra beats, caused a waste of 4,300 pounds of force ; that is, of force equivalent to that expended in lifting 4,300 pounds one foot high in a minute. When two ounces were employed, the wasted force was 18,720 pounds. With eight ounces of the poison, the force wasted was 254,880 pounds, or more than 127 tons extra. When we consider how much labor would be required to lift 127 tons of coal a foot high, or one-tenth of that amount ten feet high, the result seems almost incredible ; but there is neither reason nor opportunity for doubting the fact. Other observers have repeated the experiments, and with similar results. Dr. Richardson finds the results confirmed by his experiments upon animals. If the force of the heart should be taken at fifty pounds, as estimated by some of the most eminent physiologists, the results would, of course, be five times as great as those given. Dr. Parkes observed that after the conclusion of the experiment, five or six days elapsed before the young man recovered his natural condition, before the alcohol was fully eliminated, the heart in the meantime remaining weaker than natural, as shown by the sphygmograph. The Whisky Flush • — The flushing of the face caused by alcohol is an evidence of relaxation or paralysis of the small blood-vessels al- ALCOHOL LESSENS MUSCULAR STRENGTH. 4G1 ready mentioned. This flushing is not confined to the face. It ex¬ tends to the liver, the kidneys, the muscles, the lungs, the spinal cord, the brain, — every part of the body. It means paralysis. Alcohol Lessens Muscular Strength.— The use of alcohol, even in moderate, doses, lessens the muscular strength of an individual, first temporarily, and then permanently. Actual experiments have shown repeatedly that a man cannot lift so much immediately after drinking an alcoholic liquor as he could before. Dr. Parkes in another experiment gave a strong, healthy man only water for drink for three days, and kept him digging during the time ten hours a day. The average number of heart -beats was sixty-six per minute. Then he worked three days more in the same manner, only taking twelve ounces of brandy each day. The average num¬ ber of heart-beats during the latter period was seventy-one per min¬ ute. The laborer began with the belief that he could work easier with brandy than without it ; but he entirely changed his opinion. He stated that during the first two days the brandy made him feel as though he could accomplish more ; but when he attempted to do it, he found himself unable to succeed. On the third day he was feverish and thirsty, had palpitation of the heart, and was obliged to stop his work very often because “ his breathing was not good.” The reason why the laborer could not accomplish so much work with alcohol as without is evident. He was wasting a part of his available force in eliminating the poison. The increased action of the heart is but one of the sources of loss of energy, and by this means alone he wasted fifty pounds of force a minute, or three-fourths of a ton air hour, or eighteen tons in each twenty-four hours. By the lungs as much more force was wasted, to say nothing of the immense waste occasioned by increased work imposed upon the kidneys, skin, liver, and other im¬ portant vital organs. The same thing has been repeatedly demonstrated in cases m which total abstainers have been brought into competition with drinkers, in trials of endurance. When other circumstances have been equal, the teetotalers have always come off victorious in such contests. Says Dr. Brinton, a recognized medical authority, “ Even a moderate dose of beer or wine diminishes the maximum weight which a person can lift to something below his teetotal standard.” Facts obliged Dr. Brinton to make this statement, though himself not a teetotaler. Dr. E. Smith, F. Pc. S., refers to “the diminution of muscular power ” 4 62 STIMULANTS AND NARCOTICS. as one of the properties of alcohol, and adds, “ In whatever dose, the di¬ rection of the action of the alcohol must be the same.” Alcohol Decreases Aiiimal Heat.— Notwithstanding: alcohol has long been used by those exposed to cold, under the supposition that it increases heat, the investigations of Dr. Richardson and others have demonstrated that alcohol invariably decreases animal heat in all cases, and in proportion to the dose. The deceptive sensation of warmth which immediately follows its use is due to the increased surface circula¬ tion. The temperature of the body quickly falls below the normal standard, in persons who are drunk reaching to three or more degrees below the natural temperature of the body, according to Dr. Dobell. In cases of deep intoxication by alcohol the temperature has been known to fall six or seven degrees below normal. The dram-taker feels warmer after drinking ; but the thermometer shows that his temperature is really less, just as actual experiment shows that he is weaker, though he may feel increased strength. It is com¬ monly observed that persons recovering from drunkenness feel chilly when coming out from under the influence of the drug. It is often some hours before the bodily heat is recovered. Alcohol as a Cause of Disease. — From the effects of alcohol upon the several important organs and systems of the body, briefly described, it is clear that it must be a powerful cause of disease. That this is the case we shall now attempt to show. \\ liile the body is growing, and before full maturity of physical structure has been attained, the effects of alcohol are for the most part temporary. Great disturbances are produced by its invasion of the vital economy, but as these are only the result of deranged functions, or func¬ tional disease, recovery is usually quite rapid when the cause is sus¬ pended. Some of the functional maladies resulting from alcohol we will now consider. Drunkard s Dyspepsia. — A drunkard is certain to become a dys¬ peptic. Alcohol tans the stomach, rendering it inactive, and causing atrophy of the glands which form the gastric juice. The supply of this digestive fluid is thus diminished. Alcohol precipitates the pepsin from the gastric j uice, and so renders useless that which is secreted. Digestion O cannot progress while alcohol is in the stomach, being delayed until the poison can be absorbed. Dr. Beaumont had an excellent opportunity for observing the ef- NUMEROUS FUNCTIONAL DISEASES. 463 fects of alcohol upon the stomach in the case of Alexis St. Martin, a young man the interior of whose stomach was exposed to view through an opening in the abdomen. St. Martin had been addicted to the use of liquor, and sometimes broke away from the restraints imposed upon him by the doctor’s experiments, and indulged his appetite for alco¬ holic drink. After these occasions, Dr. Beaumont always noticed that the mucous membrane of the stomach was greatly congested. Even the use of a small quantity of alcoholic drink was sufficient to pro¬ duce an inflamed appearance, while greater excess caused the stomach to present a surface swollen and roughened with inflammation, with ulcers and numerous black patches of deadened tissue. Notwithstanding this terrible condition of his stomach, St. Martin was scarcely conscious of any disturbance, and thought himself as well as usual ! Why was this ? Because the stomach has few nerves of general sensibility, and suffers long before it remonstrates. The stomach of an habitual drinker resembles pounded beefsteak more nearly than any human tissue, as may be seen by reference to Plate XIV. When long continued, alcohol produces worse effects; it causes in¬ flammation of the stomach, foul ulcers, and cancerous disease of the organ. Not long since, we saw in Bellevue Hospital, New York, a case of most violent gastritis produced by taking a small quantity of alcoholic drink. The patient was a woman, and for several days she was unable to retain any food in the stomach. Nutrition was main- ' tained by nutritive enemata. The most obstinate cases of gastric ulcer are found in drunkards. Numerous Functional Diseases. — Close upon the derangement of the stomach, which is certain to come sooner or later with all drink¬ ers, follows nearly every other functional disease possible to the human system. Every organ is disturbed. The whole vital machinery is de¬ ranged. Strange noises are heard in the head, occasioned by the rushing of the hot torrent of poisoned blood through the distended blood-vessels of the head, which pass near the ear. Black spots and cobweb appearances annoy the sight. Alcoholic amaurosis or am¬ blyopia comes on, and sight becomes impaired ; sometimes blindness follows. The dilated blood-vessels of the skin become permanently enlarged, especially in the face and nose, and the drinker gets a rum blossom. Skin diseases of various sorts are likely to appear, particu¬ larly eczema of the fingers or toes, or on the shins. An unquenchable 464 STIMULANTS AND NARCOTICS. thirst seems to be ever consuming the blood, and nothing but alcohol will even temporarily assuage the desire for drink. Notwithstanding, large quantities of fluids will be taken, often amounting to several quarts a day, which overworks the excreting organs. The liver and kidneys are disturbed in their function, one day being almost totally inactive through congestion, and the next rally¬ ing to their work and doing double duty. Every organ feels the effect of the abuse through indulgence in alcohol, and no function is left undisturbed. By degrees, disordered function, through long continuance of the disturbance, induces tissue change. The imperfectly repaired organs suffer more and more in structure until the most extensive and disastrous changes have taken place. Organic Diseases Induced by Alcohol. — The most common form of organic or structural disease due to alcohol is fatty degeneration, which may affect almost every organ in the body. The Drunkard’s Heart. — The fatty particles which exist in such increased abundance in the blood of those who use alcohol, are, after a time, deposited in various tissues where they are not needed, and in too great quantities. This deposit often occurs in the heart, and gradu¬ ally replaces the muscular tissue of its Avails, thus weakening the heart’s power, and rendering it liable to fail altogether when called upon for a little extra exertion, and even to rupture from the force of its own feeble contractions. It is a fact well known to physicians that this is one of the most common causes of heart disease. We ha\re seen scores of cases of heart disease in the large hospitals of New York, and elsewhere, the larger share of which were in persons addicted to the use of liquor. Alcohol a Cause of Apoplexy. — The fatty particles contained in the blood are very liable to be deposited in the walls of the arteries, as well as in those of the heart. The arteries of the brain are more frequently the seat of this degeneration than those of any other part of the system. Its presence here can be detected by the arcus senilis, an almost certain sign hung out by nature to give warning of the dangerous changes taking place. The arcus senilis is a yellowish ring formed in the cornea, just within the outer edge. It is caused by a deposit of fat, and indicates that the same change is taking place in the brain. Alcoholic Consumption. — Dr. Bichardson points out the fact that alcohol, instead of preventing, actually produces consumption, ALCOHOLIC INSOMNIA. 465 and of a most fatal type. He states that a person suffering from alco¬ holic phthisis shows no improvement under treatment. The disease, steadily, surely, and usually quite rapidly, progresses to a fatal termi¬ nation. The disease is most liable to attack those who seem to be al¬ most invincible to the effects of alcohol, and who are often pointed to as examples of the harmlessness of alcoholic drinks. The disease often makes its appearance just when the drinker, alas ! too late, is making up his mind that the poison is really hurting him, and is thinking of reforming. The Gill Liver. — The appearance of a drunkard’s liver is charac¬ teristic. “ Hob-nailed liver ” is another name for the diseased organ as found in spirit-drinkers. It is shrunken, hard, and almost totally useless, insensible alike to pain and to proper sensibility. Externally it looks like the hob-nailed sole of an English cartman’s shoe, from which resemblance it received its name. This kind of liver is found in those who have indulged in drink for several years. The livers of more moderate drinkers are found filled with fat. These derangements of the liver give rise to numerous other dis¬ turbances, of which abdominal dropsy is one common form. Diabetes, a very fatal malady, especially in spirit-drinkers, is a peculiar disease which is generally caused by some of these derange¬ ments of the liver. Alcohol a Cause of Kidney Disease, — All of the different forms of disease of the kidneys, commonly known under the name of Bright’s disease, are common consequences of the use of liquor. The kidneys become worn out with overwork, and undergo the same degenerative changes suffered by other important vital organs. An eminent au¬ thority states that in England seven-eighths of all cases of disease of the kidneys are due to alcohol. This fact may account for the increas¬ ing prevalence of disease of the kidneys, especially in countries where strong liquors are used. Alcoholic Insomnia. — While alcohol at first acts in many persons as a soporific, its final effects are to produce inability to sleep ; or, if sleep is not wholly broken, a disturbed, unnatural, unrefreshing state of unconsciousness, hardly worthy of being called sleep, is induced. In natural sleep the supply of blood to the brain is greatly diminished, only a sufficient amount of the nutritive fluid circulating in the arte- 30 46G STIMULANTS AND NARCOTICS. ries to carry on the reparative work of the brain. Unconsciousness is due to this fact. A condition of unconsciousness may also be produced by extreme congestion of the brain, a condition closely allied to that which just precedes apoplexy. This is the sleep of the drunkard. If he is not kept awake, through morbid, disordered action of the brain, due to an increased blood supply in its paralyzed arteries, he falls into an apoplectic slumber, in which he is haunted by horrid nightmares, goblins, ghosts, and frightful imagery, and awakes unre¬ freshed, unrecuperated. This unrefreshing sleep is produced by chloral and other narcotics, as well as by alcohol, a fact which shows the folly of attempting to remedy the alcoholic disease by dosing the natient with other drugs equally bad if not worse. The only proper remedy is total abstinence, and this will usually effect a cure, unless the condition of paralysis of the cerebral blood-vessels has been so long continued that the power of contraction cannot be restored to them. Nervous Disorders of Driukers. — No class of persons are so sub¬ ject to nervous diseases due to degeneration of nerves and nerve-cen¬ ters as drinkers. The constant congestion of the brain and spinal cord occasions thickening of the membranes which inclose and protect these delicate parts, and gives rise to fatty degeneration and hardening, which causes loss of function. The paralytic condition which is at first temporary, existing only while the person is under the influence of alcohol, and manifested as partial or complete loss of muscular power, according to the dose, by degrees becomes permanent, as does also the loss of power to regulate or co-ordinate muscular effort, shown in the staggering steps of the drunkard. Partial or general paralysis, locomotor ataxia, epilepsy, and a host of other nervous disorders, are directly traceable to the use of alcohol. Alcoholic Insanity and Idiocy. — The wild delirium of drunken¬ ness, mania a potu, is too common to require description. By degrees, this condition may become permanent, through degeneration of the brain. The effect of alcohol upon the brain is particularly marked. It is possible to distinguish by the microscope and other means, the drinker’s brain from that of an abstainer. The brain, when healthy, is so soft that it would not retain its shape but for the skull. The sharpest knife is required to cut it with¬ out mangling its structure. It is necessary to immerse the organ in alcohol for weeks or months in order to harden it when a careful ex- ALCOHOL PREDISPOSES TO DISEASE. 407 animation is essential. A drunkard’s brain presents a marked con¬ trast. It is already hardened, pickled almost. In the dissecting room, it affords rare pleasure to a medical student to secure the dessicated brain of an old toper. The quantity of alcohol in the brain is some¬ times so great that it can be collected by distillation after death. Al¬ cohol has been found in the ventricles of the brain in a sufficiently pure state to burn when a match was presented- to it. Intemperance is now generally recognized as the greatest of all causes of insanity. According to the statistics of insanity in France, thirty-four per cent of the cases of lunacy among males were due to intemperance. One-half of the inmates of the Dublin insane asylum owe their disease to the use of liquor. Lord Shaftesbury, chairman of the English Commission on Lunacy, in his report to Parliament stated that six out of every ten lunatics in the asylums were made such by alcohol. Dr. Willard Parker, one of the oldest and most eminent physicians of New York City, remarks as follows on this point: — “ Pritchard and Esquirol, two great authorities upon the subject, at¬ tribute half of the cases of insanity in England to the use of alcohol. Dr. Benjamin Rush believed that one-third of the cases of insanity in this country were caused by intemperance, and this was long before its hereditary potency was adequately appreciated. Dr. S. G. Howe attributed one-half of the cases of idiocy in the State of Massachusetts to intemperance, and he is sustained in his opinion by the most relia¬ ble authorities. Dr. Howe states that there were seven idiots in one family where both parents were drunkards. One-half of the idiots in England are of drunken parentage, and the same is true of Sweden, and probably of most European countries. It is said that in St. Petersburg most of the idiots come from drunken parents.” Alcohol Predisposes to Disease. — The great number of observa¬ tions on this subject leaves no room to doubt that the use of alcohol is one of the most potent influences in increasing the susceptibility to the influence of disease. It is in no sense a preventive. Dr. Anderson, of Glasgow, says, “ I have found the use of alcoholic drinks to be the most powerful predisposing cause of malignant chol¬ era with which I am acquainted. In Warsaw, ninety per cent of all who died of cholera during the epidemic of 1832 were habitual drink¬ ers.” In the city of Tiflis, containing 20,000 inhabitants, every drunkard was swept away by cholera. In the Park Hospital, New 4G8 STIMULANTS AND NARCOTICS. York, there were two hundred and four cases of cholera during an epidemic of the disease. Of these, only six were temperate, and they recovered, while two-thirds of the remainder died. In the late epidemic of yellow fever in this country the proportion of victims among inebriates was nearly as large. “ Four-fifths of those who were swept away by the dreadful visita¬ tion of the cholera in 1832 were addicted to intoxicating drinks.” The whole population of St. Petersburg and Moscow ceased drink¬ ing liquor, being convinced that it was almost certain death to con¬ tinue its use. M. Huber said, “ Persons given to drinking were swept away like flies.” Alcohol predisposes to other diseases as well as cholera. A very slight injury to an intemperate man is likely to result fatally. Sur¬ geons in city hospitals find that they cannot expect the same degree of success in operations upon drinkers that they expect in the cases of temperate persons, a very slight operation, which would have occa¬ sioned no inconvenience in a total abstainer, often ending fatally. Stanley says, “No drunkard can live in Africa.” It is also well known that English soldiers in warm climates suffer from disease just in proportion as they indulge in liquor or abstain from its use. Dr. W. B. Carpenter cites in proof of this fact the returns of the sickness of European troops of the Madras army for 1849, in which the men were classed as abstainers, temperate, and intemperate. The report showed that the relative proportions of these classes admitted to hos¬ pitals were sixty abstainers and sixty-six temperate, to one hundred intemperate. The same difference is shown in England between the Sons of Temperance and the Odd Fellows’ Associations. The average number of days of annual sickness for each member of the Sons of Temperance was five; that for the members of the Odd Fellows’ Unity, many of whom, though not all, used liquor in a moderate degree, was seven and seven-tenths days, or an excess of more than one-half. The following formidable array of maladies has been attributed to the direct or indirect influence of alcohol : — Gout, rheumatism, heart disease, dyspepsia, disease of kidneys, dropsy, obesity, disease of the liver, apoplexy, degeneration of the muscles, tremors, ulcers, insanity, palsy, jaundice, epilepsy, consump¬ tion, melancholy, cancer, amaurosis, paralysis, hysterics, convulsions, ALCOHOL DECREASES LONGEVITY. 469 gastritis, enteritis, ophthalmia, carbuncle, boils, fatal obstruction of lacteals, tabes, syncope, diabetes, lockjaw, idiocy, impotency, mania, delirium tremens, Bright's disease, disease of the arteries, atrophy of the liver, congestion of the liver, and numerous other organic and fund ional derangements. W e were informed by one of the visiting physicians of Bellevue Hos¬ pital, New ^ ork, that at least two-thirds of all the diseases treated there originated in drink. Much additional testimony and an almost unlimited number of facts might be further adduced in support of these statements, but the above may suffice. We shall now undertake to show that — - The Use of Alcohol Decreases Longevity. — It is very easy to prove that the influence of alcohol, as of every other poison, is to shorten life. Dr. Willard Parker, of New York, shows from statistics that for every ten temperate persons who die between the ages of twenty-one and thirty, fifty-one intemperate persons die. Thus it appears that the mortality of liquor-users is five hundred per cent greater than that of temperate persons. These statements were based on the tables used by life insurance companies. Notwithstanding the constant protest of both moderate and immod¬ erate drinkers that alcohol does not harm them, that it is a necessary stimulus, a preventive of fevers, colds, consumption, etc., and the asser¬ tion of certain scientists that it is a conservative agent, preventing waste and so prolonging life, the distinguished English actuary, Mr. Neison, has shown from statistical data which cannot be controverted, that while the temperate man has at twenty years of age an average chance of living forty-four and one-fifth years, the drinking man has a prospect of only fifteen and one-half years of life. At thirty years of age the temperate man may expect to live thirty-six and one-half years, while the dram-drinker will be pretty certain to die in less than fourteen years. A London Life Insurance Society divides its insurers into two classes, abstainers and moderate drinkers. It is found that during the last twelve years the mortality has been one-fourth less among abstainers than among the moderate drinkers; that is, only three abstainers die to four moderate drinkers. Dr. Magnus Huss asserts that in Sweden 1,500,000, or about one- half the whole population, annually consume an average of one hundred and sixty pints of spirits each. By this excessive indulgence in drink, the Swedes already show distinct marks of deterioration in stature and longevity. 470 STIMULANTS AND NARCOTICS. Between 60,000 and 100,000 persons die annually in America alone from the effects of liquor. A still larger number die in Europe from the same cause. Then in these two countries a human being dies every two and one-half minutes from alcoholic poisoning. The graves of the victims, allowing twelve square feet for each, would in fifty }rears nearly cover a township. Arranged end to end, their coffins would make a continuous line from Gape Horn to the North Pole. Arranged in one long funeral procession, with a hearse and a single vehicle for mourners for each, this vast army of dead drunkards would occupy two and a half years in passing a given point, and would wind two and one-half times around the globe. Effects of Moderate Drinking. — Moderate drinkers do not es¬ cape. “ Chronic alcoholism ” is the disease which fastens upon them, and its symptoms are as distinct as those of any other disease. Gout and rheumatism are the special patrons of the moderate topers, the wine-bibbers. Neuralgia is another comforter of small tipplers. Gen¬ eral nervous debility and dyspepsia also find a great proportion of this class among their victims. It is quite useless for moderate drinkers to suppose that by using alcohol in small quantities they escape its evil effects. It is a poison in all doses. As Dr. Smith says, “ In whatever dose, the direction of the action of the alcohol must be the same.” Says Dr. Chambers, “The action of frequent divided drams is to produce the greatest amount of harm of which alcohol is capable, with the least amount of good. ' It may be said, without exaggeration, that moderate drinking occasions all the ill effects of intemperance; for every drunkard begins his course as a moderate drinker. James Miller, in his work on Alcohol, says, “Alcohol to the work¬ ing human frame is as a pin to the wick of an oil-lamp. With this you raise the wick from time to time, and each raising may be fol¬ lowed by a burst of brighter flame ; but, while you give neither cotton nor oil, the existing supply of both is, through such pin-work, all the more speedily consumed.” Dr. W. B. Carpenter has shown that the largest quantity of alco¬ hol which can be taken daily without producing the poisonous effects and serious consequences pointed out is one to one and one-half ounces. A lai’ger amount may seem to be tolerated, but it is doing its slow work of death all the same, gradually, but surely. Judged by this HEREDITARY EFFECTS OF ALCOHOL. 471 standard, which is based upon scientific facts admitted alike by the advocates and opponents of the use of alcohol, a large proportion of those who use alcohol at all are being slowly poisoned by it. The effect of the constant action of a small quantity of the poison is far greater than that of excessive, but only occasional, quantities. Hence the habitual moderate drinker, even of wine, beer, or hard cider, is much more subject to chronic nervous disorders and degenerations of various sorts than the man who goes on a spree once in two or three months. Hereditary Effects of Alcohol . — The drinker himself is not the only sufferer from his vice. Indeed, it seems in many cases that he is not the greatest sufferer. He may even live out his threescore years and ten, in apparent defiance of the laws of nature and the warn¬ ings of friends ; but look at his children. Are they as strong and robust as he ? Oh! no; instead, we often see them frail, nervous, imbecile, idi¬ otic, — poor specimens of the race. The iniquities of the father are visited upon the children. “ There are those [thousands] who have had diseased physical organ¬ isms bequeathed to them, and they are suffering from an irritable brain and an eccentric habit of thought, because their fathers drank spirits.” — Dr. Edmunds. Says the eminent Dr. Parker, whom we have before quoted: — “ The hereditary influence of alcohol manifests itself in various ways. It transmits an appetite for strong drink to children, and these are likely to have that form of drunkenness which may be termed paroxysmal ; that is, they will go for a considerable period without indulging, placing restraints upon themselves, but at last all the barriers of self-control give way ; they yield to the irresistible appetite, and then their indulgence is extreme. The drunkard by inheritance is a more helpless slave than his progenitor, and the children that he begets are more helpless still, unless on the mother’s side there is engrafted upon them untainted stock. But its hereditary influence is not confined to the propagation of drunkards. It produces insanity, idiocy, epilepsy, and other affections of the brain and nervous system, not only in the transgressor himself, but in his chil¬ dren, and these will transmit predisposition to any of these diseases.” Probably nowhere in the civilized world; — unless it be among the na¬ tives of the Sandwich Islands who are being rapidly exterminated by drink — are the baneful effects of alcohol upon the race seen more vividly than in Norway and Sweden. In Norway the spirit duty was removed 472 STIMULANTS AND NARCOTICS. in 1825. In the next ten years insanity increased fifty per cent, and the number of children born idiots increased one hundred and fifty jper cent. In Sweden there are at least a million and a half persons each of whom annually consumes eighty to one hundred quarts of whisky. Young children drink with their parents; and even infants are quieted to sleep by giving them a rag soaked in whisky to suck. According to Dr. Huss, the consequence of this is that “ the whole people is degenerat¬ ing; that insanity, suicide, and crime are frightfully on the increase; that new and aggravated diseases have invaded all classes of society; that sterility and the premature death of children are much more com¬ mon; and that congenital imbecility and idiocy are in fearful proportion to the numbers born.” Effects of Alcohol upon the Character. — The ultimate effects of al¬ cohol upon the character are well shown by its immediate effects. As the cerebrum is gradually brought under the influence of the drug, the will becomes dormant and the leading characteristics of the mind become predominant. A man under the influence of liquor shows out his real character. The restraining influences of culture and education are lost, and those tendencies and properties which have been held in check by force of will, assert their sway, and all that is low and beastly in the in¬ dividual comes to the surface. It is this that causes individuals to com¬ mit, under the influence of drink, crimes which they would never have perpetrated in their sober moments. It is rare indeed that a premedi¬ tated murder is committed without the murderer being' under the influ- ence of drink. He feels the need of something to paralyze the voice of conscience and make powerless the moral force of education, of natural regard for human life; and alcohol does just that. When liquor is frequently indulged in, the lowered moral status be¬ comes, after a time, a permanent state, which has been thus graphically pictured by Dr. Fothergill : — “ The most pronounced product [of alcoholic demoralization] is found in the hopeless drunkard, who, in squalid rags, with rotten tissues, the embodiment of intellectual and moral degradation, utterly beyond hope, the line of possible restoration long past, hangs around the tavern door, and with the odor of alcohol floating on his breast, whiningly begs a cop¬ per from the mass of vitality around him, of which he himself is a withered and decaying branch. This man is incapable of labor; he is unwilling to entertain the idea of toil. He is beyond any capacitv for labor; he is no longer capable of discharging his duty as a citizen; he is EFFECTS OF ALCOHOL UPON THE CHARACTER. 473 a social parasite of the lowest and foulest order, as useless as a tape- worm. He has abandoned all self-respect, because there is nothing left in him for himself or any one else to respect. He is a shameless liar, who will make the most solemn protestations as to the truth of what it is patent enough is false. There is no depth of moral degradation to which he will not descend for means to purchase a little more of the fluid which has ever been his bane.” It has been estimated oy competent judges that intemperance is the cause of nine-tenths of all the crime among civilized nations. Alcohol benumbs the intellect, deadens conscience, and stifles reason. It leads its victim to theft to secure the means of indulgence, and steels the heart of the assassin for his bloody work. To the crimes committed by the users of alcohol, themselves, should be added those committed by the wives and children of drunkards, who are driven to desperation and crime by the want and suffering occa¬ sioned by the cruel monster, drink. The influence of liquor in inci’easing crime has often been well illus¬ trated by the sad results which have invariably followed its first intro¬ duction into any community. Many newly settled districts have existed for several years with entire exemption from crime; no murders, no thefts, no public broils, no assaults upon persons or property, no act of violence of any kind occurring to mar the peace and destroy the feeling of security of the community. At last a public house is opened in the midst of this prosperous and peaceful society, and a bar is erected, from which alcoholic liquors are dispensed. The evil consequences are imme¬ diately apparent. Drinking engenders idleness. Idleness necessarily brings want, and want leads to theft; for a man who spends money for illegitimate purposes will not long continue particular to obtain his means from legitimate sources. Idleness and the conscience-searing, pas¬ sion-stimulating influence of alcohol soon lead to acts of violence against persons and disregard of individual rights. Midnight carousals and drunken revels become frequent, outbreaking crimes are not uncommon, and the once peaceful community becomes a scene of constant disturb¬ ance and disquiet. The sheriff and constable, who previously found no occasion for the exercise of the functions of their offices, now find con¬ stant employment. A jail becomes a necessity, and is never without an occupant. To say that alcohol is responsible for the revolution in the condi¬ tion of such a community, would be to state a fact too plain to be mistaken. 474 STIMULANTS AND NARCOTICS. Another evidence of the influence of liquor-drinking upon crime is seen in the fact that crime increases and decreases in any particular locality almost in proportion to the increase and decrease of the use or sale of liquor. During seven years, from 1812 to 1818, the annual consumption of liquor in England and Wales was 5,000,000 gallons; during the same period, 11,000 persons were annually arrested and committed for trial. During the seven years from 1820 to 1832, 9,000,000 gallons of liquor were annually consumed, and the annual number of arrests was 21,700. It will be observed that the amount of liquor sold during the last period was almost double that consumed during the first, and also that the number of arrests was nearly doubled during the last period. That this increase of crime was due to the influence of liquor and not to increase of population, is shown by the fact that while crime had doubled, the population had increased but one-third. Says Dr. Nott, “ In Scotland, in 1823, the whole consumption of intoxicating liquors amounted to 2,300,000 gallons ; in 1837, to 6,776,- 715 gallons. In the meantime, crime increased 400 per cent , fever 1,000 per cent, death 300 per cent, and the chances of human life di¬ minished 44 per cent. . “ In Ireland, when the distilleries were stopped, in 1808, crime de¬ creased amazingly. Again, when in 1810 they recommenced opera¬ tions, the commitments increased nearly fourfold.” — Bacchus Dethroned. The increase of crime incident to the increased use of liquor is, of course, due to the influence of alcohol upon the moral nature of indi¬ viduals. The direct effect of this poisonous drug seems to be to para¬ lyze the will, to render the sensibilities obtuse, to deaden the con¬ science, to inflame the passions, to weaken the judgment, and to de¬ throne reason. Kleptomania (an uncontrollable disposition to steal) is one of the acknowledged effects of drink. It is a well-established fact that the “ social evil ” is largely sup¬ ported by the use of liquor. Brothels and public houses are fre¬ quently connected. Liquor and licentiousness go hand m hand. An eminent physician remarks with reference to the moral effects of alcohol, “ When alcoholism does not produce insanity, idiocy, or ep¬ ilepsy, it weakens the conscience, impairs the will, and makes the in¬ dividual the creature of impulse and not of reason. Dr. Carpenter regards it as more potent in weakening the will and arousing the more violent passions than any other agent, and thinks it not improbable adulteration of alcohol. 475 that the habitual use of alcoholic beverages, which are produced in such great quantities in civilized countries, has been one great cause of the hereditary tendency to insanity.” Dr. Elisha Harris, late President of the American Public Health Association, and Corresponding Secretary of the New York Prison As¬ sociation, states that of 100,000 prisoners 82,000 were committed through the influence of drink. Adulteration of Alcohol. — \Ve have scarcely mentioned the fact that alcohol is subject to adulteration to an almost unlimited extent, as we do not regard this fact as of so very great importance, since alco¬ hol is the chief poison in all liquors, whether adulterated or not, and, with rare exceptions, is worse in its effects than any of its adulter¬ ants. It may be remarked, however, that there is very little pure liquor to be obtained. The following substances with many others are used in adulterating: the various alcoholic beverages hi common use : — Burnt sugar, sulphate of potash, sulphate of iron, alum, salt, coc- culus Indicus, picric acid, colchicum, tobacco, capsicum, ginger, wormwood, sulphuric acid, cream of tartar, carbonate of potash, hartshorn, strychnia, lead, laurel-water, cochineal, logwood, sugar of lead, oil of turpentine, gentian, and opium. THE MEDICAL USE OF ALCOHOL. This question is one which at the present time is exciting a great degree of interest in the medical world, and we should neglect an im¬ portant part of our task if we should fail to devote the space to it which its importance well demands. The medical use of alcohol is the strong fortress into which the moderate drinker runs when hard pressed by the advocates of total abstinence. It has always been a sort of Gibraltar for intemperance. The admission of the medicinal use of alcohol as a stimulant, tonic, conservator or generator of vital force, has been the rotten plank in the temperance platform. It has made the defenses of teetotalism, otherwise impregnable, exceedingly vulnerable. Temperance reform¬ ers have kept this part of the subject in the background as much as possible ; but moderate drinkers have persisted in making it promi¬ nent on every possible occasion, often to the great discomfiture of the advocates of total abstinence for the well, but unlimited indulgence for the sick. 47G STIM ULA NTS A XD NA RCOTICS. It has become evident to those who have given the matter candid thought, that either the common employment of alcohol as a medicine is a stupendous error, or teetotalism is a fanatical delusion. W hich of these positions is the true one ? It must certainly be that one which best agrees with facts — scientific facts — and the dictates of rea- son and common sense. No other drug is employed so largely in medicine as alcohol. It is not only prescribed in the form of alcoholic drinks, but, in combina¬ tion with other drugs, in all tinctures, and many other pharmaceutical preparations. Still greater quantities reach the stomachs of the peo¬ ple through a host of quack remedies, patent medicines, known under various delusive names, as cordials, bitters, tonics, restoratives, etc. Medical Properties of Alcohol. — According to the classical au¬ thors on materia medica, alcohol is a nervine, stimulant, tonic, nar¬ cotic, diaphoretic, diuretic, and caustic. Its varied properties are urged as sufficient apology for its so general use, they making it ap¬ plicable, as supposed, to almost any actual or imaginary case of disease. It should be remarked that a medical property is not, as generally supposed, a certain mode of acting upon the system possessed by a drug, but rather an indication of the manner in which the system acts toward the drug. It is evident, then, that the medicinal properties of alcohol, before enumerated, are so many terms for indicating a corre¬ sponding number of disturbances or disorders which the drug occa¬ sions in the body. When medical authors say that alcohol acts so and so, we must understand them to mean only that the drug occasions such an action on the part of the system. As the relations of any drug to the body in disease are determined by observing its effects upon the body in health, it will be instructive for us to glance again, for a moment, at the effects of alcohol upon liv¬ ing tissues as determined by experiment. When applied to plants, says Pereira, a noted medical writer, ‘ al¬ cohol acts as a rapid and fatal poison.” Says the same author, “ Leeches immersed in spirit die in two or three minutes.” Frogs and snakes are affected in the same manner. We have seen the heart of a turtle contracting vigorously several hours after removal from the body of the reptile. When placed in alcohol, its contractions cease in less than a minute. MEDICAL PROPERTIES OF ALCOHOL. 477 Alcohol causes paralysis when applied directly to the trunk of a nerve. It has the same effect when applied to a ganglion. If a pig¬ eon’s brain be exposed by removing a portion of its skull, alcohol may be applied directly to the cerebellum. The effect produced is essen¬ tially the same as that which follows the removal of the cerebellum by the knife. The poor pigeon plunges and staggers about like a drunken man, and for precisely the same reason. If a little alcohol is added to a vessel of water containin'; live min- nows, they will speedily die. Applied to the skin, and retained by some impervious covering to prevent evaporation, alcohol produces irritation and numbness. Applied to the mucous membrane of the eye or mouth, still greater irritation is occasioned. When taken into the stomach undiluted, it produces intense irritation, inflammation, and ulceration, as proved by Dr. Beaumont’s observations upon Alexis St. Martin. When mingled with the blood, alcohol destroys the blood corpuscles, increases the proportion of fat, renders the blood less capable of passing readily through the capillaries, coagulates the fibrine, and injures the nutrient elements of the plasma of the blood. When a considerable quantity of alcohol is taken, the distinction between venous and arterial blood is almost destroyed, all of the blood assuming a dark hue. It was thus that the English nobility, through habits of dissipation, became dis¬ tinguished for their blue blood, which was by them considered an evi¬ dence of noble origin. But alcohol does not remain in the blood. It permeates every tissue, and for some curious reason not yet satisfactorily explained, accumulates in nerve tissue more than in any other, unless it be the liver, which would very naturally receive the most, since alcohol when received by the stomach is carried directly to the liver by the portal vein, as soon as absorption occurs. The effect of alcohol upon the nerves is to lessen sensibility. A man whose nerves are bathed in alcohol has the acuteness of all of his senses somewhat impaired. The degree of impairment depends upon the amount of alcohol present. A large quantity of alcohol destroys sensi- « bility entirely. We have observed that alcohol is ‘‘a rapid and fatal poison to plants,” that it kills leeches, frogs, reptiles, and minnows, that it irri¬ tates the skin and mucous membrane, destroys the blood, and paralyzes 478 STIMULANTS AND NAIWOTICS. the nerves. In considering these effects, Prof. Christison, Dr. Pereira, Dr. Taylor, Prof. Orfila, and other authorities of equal note, pronounce it a “ narcotico-acrid poison.” Says Dr. E. Smith, “ It is a poison of the nervous centers.” Says Dr. Edmunds, of England, “ There is no great city on our side of the ocean where there are not inquests held upon men who drink a bottle of brandy, and fall down and die just as if you had given them a spoonful of prussic acid. Alcohol is a poison.” Says Dr. Willard Parker, of New York, “ By physiological inqui¬ ries it has been established that alcohol is a poison.” The Vital Instincts Treat Alcohol as a Poison. — If there should remain the least shadow of a doubt in the mind of any one that alcohol is a poison, it must certainly be removed by considering how the system treats this drug when it is taken into the stomach. At first the mucous membrane becomes congested, and throws out a quantity of mucus to protect itself from the alcohol, while the ab¬ sorbents increase their activity for the purpose of getting the drug out of the stomach as quickly as possible. Having entered the blood, it is transported at once to the liver, which does its best to extract as much as possible of the poison, though at im¬ minent peril to itself. Very soon the poison-laden blood reaches the heart. This organ also recognizes the drug as something which has no place in the blood and ought to be removed ; and, as it cannot directly effect the removal itself, it pumps a little harder at the circulation in order to hurry the impure blood along to those organs which are espe¬ cially designed to remove impurities. Hence the increased force and frequency of the pulse. The first of these organs which the hastening blood reaches, is the lungs, and here the volatile poison is sent out in volumes. Every one knows that a drunkard’s breath smells like a beer shop. The alcohol is also expelled by the kidneys and the skin, and can be found in the urine and the perspiration. In fact, every excretory organ of the body is engaged in getting rid of this poison. A food or a friendly substance is not treated in this way. If alcohol is a good thing, it is certainly very much abused by the vital instincts. But the vital instincts are not easily deceived. They recognize food in an entirely different manner. An apple, a potato, milk, or bread, when taken into the body, is utilized. It disappears, and never re-appears as NAME AND PROPERTIES. 479 milk, or bread, or apple, or potato. Not so with alcohol. It enters the system alcohol, and leaves it precisely the same as it entered, remaining the same all the way through. Instead of retaining the drug, digesting and assimilating it, the system hurries it out in every possible way. The escaping poison can be detected in the breath for more than twenty- four hours after a small quantity has been taken. It is long retained in the body, and has been distilled from the brains of drunkards thirty- six hours after its reception into the body. If, after eating apples, potatoes, and sundry other articles, the same articles should be found, upon a post-mortem examination, in various por¬ tions of the body, apples in the brain, potatoes in the liver, and other * articles in other parts, it would be considered as the most indubitable evidence that those articles, — apples, potatoes, etc., — were not food, since they were not used or changed in the body. If we found these same articles passing out of the body, we should be led to the same conclusion. This is just the experience with alcohol. The conclusion, then, is una¬ voidable, that it is not food, but poison, as eminent physicians have de¬ clared. Says Dr. Parker, again, of alcohol, “ It is not a food, nor should it be used as a common beverage.” Does a Change of Name Change Properties? — Here we are met with the argument that alcohol, though a poison to the well, is still a good remedy for the sick. This paradoxical statement is explained by the assumption that the conditions of the system in disease are so differ¬ ent from those present in health that the relations of the vital organs to alcohol are totally changed. If this assumption be true, then tcetotalism is a terrible delusion ; for where can a drunkard be found whose system is not in a state of disease? If it is true, then what a curse to the world temperance reformers have been ! How many reformed sots have been deprived of the “medicine” which was “ curing ” them ! But is it true ? Let us see. Does a simple change of location from the whisky barrel to the drug¬ gist’s shelf change its properties ? Will a change of name make it whole¬ some ? Will it make a negro white to call him a Caucasian ? Certainly not. Alcohol is a poison because it cannot be used in the body for any useful purpose, and because it produces serious disturbances in the vital processes. It is unfriendly to the tissues, and incompatible with them. When a man is sick, are not his tissues essentially the same in character as when he is well ? Are not his muscles still composed of muscular 480 STIMULANTS AND NARCOTICS. tissue ? his nerves of nerve tissue ? his bones of osseous tissue ? Cer¬ tainly. Then, since the composition of alcohol also remains the same, there can be no change in its relations to the tissues. Does Alcohol Supply Force % — Many years ago Prof. Liebig an¬ nounced the theory that alcohol was “ respiratory food.” By the term respiratory food he meant that it underwent combustion in the body and thus produced heat and developed force. All the moderate drink¬ ers and topers rejoiced at this supposed discovery, and consoled them¬ selves with the idea that taking a whisky punch was only a pleasant way of eating; and that a man when “ gloriously drunk,” was merely developing a tremendous amount of force. But scientists ascertained, after a time, that Prof. Liebig, to use the language of Prof. Davy, F. It. S., “ adduced no physiological evidence in support of his asser¬ tion.” Prof. Liebig observed that his neighbors and most of his coun- trymen loved beer, wine, and brandy; he loved the beverages himself. He observed also that nearly every nation employed some kind of alco¬ holic drink. The very natural conclusion in his mind was, alcohol is used in the body for some good purpose ; and his theory was merely an attempt to explain such a use. If Liebig’s theory were true, then alcohol would disappear in the body, and only its ashes, the products of its combustion, would ap¬ pear. Unfortunately for the theory, MM. Lallemand, Perrin, and Duroy, three French chemists, by careful experiments proved that, when taken into the body, alcohol passed out again unchanged. Hence it was not burned ; and hence it did not produce either heat or force. Dr. Edward Smith, F. It. S., repeated their experiments and confirmed their results. The fact that alcohol is unchanged in the body was still further confirmed by the observation that none of the products of the combustion of alcohol, its ashes, were to be found in the blood or the excretions. The inevitable conclusion from these experiments is that alcohol does not contribute to the production of either heat or force. Says Dr. Edward Smith, “ Its direct action is to lessen nervous force.” “ Is ‘ vital force ’ augmented by it, or not ? All the facts seem to answer in the negative.” — British Medical Journal. Says Dr. T. K. Chambers, “ Alcohol is primarily and essentially a lessener of the power of the nervous system.” “ As their general action is quickly to reduce animal heat, I can- ALCOHOL AS A STIMULANT. 481 not see how they can supply animal force. I see clearly how they re¬ duce animal power, and can show a reason for using them to stop physical pain ; but that they give strength, that they supply material for the construction of fine tissue, or throw force into tissues supplied by other material, must be an error as solemn as it is widespread .” “ To resort for force to alcohol is to my mind equivalent to the act of searching for the sun in subterranean gloom until all is night.” — Dr. B. W. Richardson. Is Alcohol Useful us a Stimulant ?— If by a stimulant we are to understand something which imparts force to the body when weak¬ ened by disease, then it is evident that alcohol can be of no service in this direction ; for, as already shown, it is incapable of supplying force, undergoing no change in the body. All force arises from changes in matter. The forces manifested by the living system are the result of vital changes occurring in its tissues. If by a stimulant is meant something which excites nervous action, which calls out the manifestation of force, then alcohol is certainly a stimulant. And it is in this sense only that it is a stimulant. The lash is a stimulant to a tired horse. It does not increase his force, or make him any less tired. It only compels him to use a little more of his already depleted strength. A goad, a spur, a red-hot iron, would have the same effect. So with alcohol. It arouses the vital instincts by its presence in contact with some of the tissues, and, in obedience to the law of self-preservation, the vital organs are excited to in¬ creased action for the purpose of expelling the poison. This increased activity is what is called stimulation. Can it benefit a person already weak with overlabor ? Says Dr. Edmunds, “ A stimulant is that which gets strength out of a man.” Such a process could not be very beneficial to a person already debilitated. But a weary man feels better after taking wine ; why is that the case ? Alcohol diminishes sensibility, as chloroform does. It is a narcotic. The weary man feels better after taking wine, because he does not know that he is weary, that his tissues need repair. If he continues to labor, he continues to wear out his tissues, and increases the necessity for rest, even though he may not know it. When the narcotizing influence of the alcohol is removed, he will be made pain¬ fully conscious of the fact by a degree of prostration far greater than he would have suffered if he had taken no alcohol. So with the sick. If a man is debilitated by disease, by a long- 31 482 STIMULANTS AND NARCOTICS. continued fever, for example, his system is weary with the task of expelling impurities from the body. Now if alcohol is administered, it is expelled as the other impurities have been. It renders the ex¬ hausted organs no aid ; it imparts no force ; it simply imposes an ad¬ ditional task. Such aid is surely not desirable. Who would think of relieving an overburdened horse by adding another burden to his load ? No sensible man, certainly. If fever patients recover after taking great quantities of wine and brandy, it is in spite of the al¬ cohol, and not by the aid of it ; for it has been proved in hundreds of instances that fever patients do far better without brandy than with it. Twenty years ago, when a man had fever he was puked, purged, bled, and salivated, under the notion that he had too much vitality, — too much life, — some of which must be got out of him. The plan of abstracting vitality was so successful that thousands of fever patients were killed who might have lived half a century if they had been so fortunate as to have had for a doctor only an old woman, or a harm¬ less homeopathist. In later times there has been a most remarkable revolution in the treatment of fevers. Calomel, emetics, purgatives, and the lancet are no longer employed in treating fevers. Instead of depleting their patients, or robbing them of their vitality, by the barbarous methods of olden times, “ regular ” physicians have adopted the theory that in fever the patient has too little vitality, and so they attempt to in¬ crease his vital force by potations of brandy, wine, and other alcoholic liquors. Of course, this practice is founded upon the theory that alcohol supplies force ; but we have already proved that alcohol does not sup¬ ply force to the body, but that it exhausts, abstracts, and paralyzes. This, then, cannot be the proper agent to employ when an addition of force is required. Says Dr. James Edmunds, of England, “ I believe, in cases of sickness, the last thing you want is to disguise the symptoms, to merely fool the patient; that if alcohol were a stimulant, that is not the sort of thing you would want to give to a man when exhausted from fever . If your patient is exhausted by any serious dis¬ ease, surely it would be the more rational thing to let him rest qui¬ etly, to save his strength, and in every possible way to take care to give him such food as will be easily absorbed through the digestive apparatus, and keep the ebbing life in the man.” WILL ALCOHOL PREVENT CONSUMPTION ? 483 The following is the opinion of Dr. Richardson on this subject : — “ It is assumed by most persons that alcohol gives strength, and we hear feeble persons saying daily that they are being ‘ kept up by stimulants.’ This means actually that they are being kept down ; but the sensation they derive from the immediate action of the stimulant deceives them and leads them to attribute passing good to what, in the large majority of cases, is persistent evil. The evidence is all-per¬ fect that alcohol gives no potential power to brain or muscle. During the first stage of its action it may enable a wearied or feeble organism to do brisk work for a short time ; it may make the mind briefly brill¬ iant ; it may excite muscles to quick action ; but it does nothing sub¬ stantially, and fills up nothing it has destroyed, as it leads to destruc¬ tion. A fire makes a brilliant sight, but leaves a desolation. It is the same with alcohol.” Does Aleoliol Prevent Waste ? — So said Prof. Liebig, who sup¬ posed that alcohol might serve as a substitute for the tissues in main¬ taining the combustion necessary to produce heat. But Prof. Liebig was mistaken. Dr. Smith, of England, proved that alcoholic drinks increase waste. It is useless, then, to give alcohol to the sick for the purpose of preventing the wasting of the body, for it will only accel¬ erate the undesirable process. Will Alcohol Prevent Consumption ?— The notion has lately be¬ come prevalent that alcohol will, in some mysterious manner, check the ravages of that dread disease, consumption. It might almost be said that in our large cities, in the practice of regular physicians, few con¬ sumptives die sober, so fashionable has this remedy become. The evidences upon which the utility of the drug in this disease is based are quite too inconclusive to amount to anything like demon¬ stration. In those cases in which recovery has taken place under the use of alcohol, the improvement can be attributed to other far more probable causes than alcohol, as impi’ovement in sanitary or hygienic surroundings or habits. © But the most conclusive evidence against the curative virtues of alcohol in this disease is found in the fact pointed out by Dr. B. W. Richardson, of London, that alcohol is itself a CAUSE of consumption. There is no evidence that spirit-drinkers are as a class less subject to consumption than abstainers, while it is certain that their mortality is much greater. Dr. Richardson has recently pointed out that the mast fatal form of consumption known is produced by alcohol. According 484 STIMULANTS AND NARCOTICS. \ to his observations, about two per cent of deaths by consumption are from this cause. The Medicinal Use of Alcohol Leads to Drunkenness.— Thou¬ sands of victims of intemperance have acquired their appetite for the fatal drug from a physician’s prescription. The doctor prescribed it as a tonic. The patient continued to feel the need of a tonic, and so he continued taking his dram as a medicine, a tonic, until he finally found, when too late, that he had become a confirmed inebriate. Hundreds of reformed drunkards who had been induced to sign the pledge, and who had kept their resolution for years, have fallen back into the gutter again through the careless administration of al¬ cohol by the family physician, and have thus been hopelessly lost to themselves and to society. We might present the touching details of many such cases ; but all have been familiar with instances of the kind, and we will not present them here. In addition to the alcohol prescribed by regular physicians, there is a still greater quantity sold and used under the name of bitters, which always consist of a filthy mixture of poisonous drugs with poor whisky. Not one of them is free from alcohol. This statement is true, notwithstanding the false asseverations of the manufacturers to the contrary. Even “ temperance bitters ” are no better than the rest. Some of these “ bitters ” contain more alcohol than the strongest liquors. By these infernal compounds, thousands of unsuspecting hu¬ man beings have been lured down to death and ruin. The popular theory that alcohol is a good medicine, helps to inspire confidence in them, and so becomes in a measure responsible for the results. The Medical Use of Alcohol an Ally of Intemperance. — The doctor gives a man alcohol because he is sick or weak. The moderate drinker takes it for the same reason. The drunkard prescribes his own “ poison ” because he feels uncomfortable, — sick. The moderate drinker takes a glass of wine to give a “ lively play of the imagina¬ tion.” When its influence is gone, his intellect is dull, his imagination clouded. He takes another glass to “ cure ” the difficulty, not consid¬ ering that the remedy is the very tiling that is making him ill. The drunkard wakes up after a night’s debauch with an aching head, ener¬ vated muscles, and trembling nerves. He takes a glass of rum to cure his bad feelings, and at once feels better. Is not rum a good medicine for him ? He thinks it is, and he has the doctors on his side, for the principle is the same whether the patient is suffering from fe- DELIRIUM TREMENS. 485 ver debility or whisky debility, — whisky cures in each case, and in the same way. Why has not the drunkard as good an excuse for curing his weak ness and bad feelings by alcohol as any other person ? Alcohol in Delirium Tremens. — Alcohol is the acknowledged cause of delirium tremens, and yet it has been long considered an es¬ sential remedy in the treatment of the very disease it had produced. While this practice would seem to be most ludicrously absurd, it has, nevertheless, been wholly consistent with the theory that alcohol sup¬ plies nervous force ; for what condition can be found in which the ev¬ idences of loss of nerve power and tone are more distinct than in this disease ? Practically, however, the use of alcohol in this disease has been a most convincing- demonstration of the fact that alcohol does not supply nerve force; for a great proportion of the patients treated with it have died. The most observing physicians have already abandoned the use of alcohol in delirium tremens, as vTe hope they will soon do in many other diseases. Here are a few testimonies : — “ I have come to the conclusion that the use of spirits in the case of delirium tremens does nothing but injure the patient, and probably hastens his death. I now, without the slightest hesitation, in every case should immediately stop the spirit, and I find that very few cases of delirium tremens that I have are fatal.” — Dr. James Edmunds. “ If you follow" the old treatment, you will lose half your cases. If you follow the treatment I give you, you wall save nearly all. In the hospitals of Edinburgh, the expectant treatment is found to save nearly all patients. They used to lose nearly all.” — Prof. Palmer, of Michi¬ gan University. Dr. Palmer recommended the expectant treatment. He also stated that, in Edinburgh, instead of narcotics the patient is given a glass of vrater with the assurance that it will make him sleep, which it usually does. Alcohol for Mothers. — It has become a notorious fact that the use of stimulants by women is increasing very rapidly, and the evil has already acquired alarming proportions. It has doubtless very largely arisen from the practice of physicians and nurses of recommend¬ ing wrine and beer to nursing mothers. The habit thus acquired is continued. But the mothers are not the only victims. A large share of the alcohol finds its way out of the system in the milk, and in this way 48G STIMULANTS AND NARCOTICS. delicate babes are kept in a state of semi-intoxication from birth until they are weaned. A mother finds her child nervous and fretful. She takes a glass of ale an hour or two before nursing the infant, and is pleased to find that he becomes quiet. She little dreams that his quietude is only the stupid narcotism of alcohol poisoning ; yet such is the truth. Every one knows that a dose of castor-oil given to a nursing mother will affect the child as promptly as the mother. The same is true of alcohol ; but the delicate organization of the infant is far more susceptible to its poisonous influence than is the mother’s sys¬ tem. Dr. James Edmunds says that a large majority of English ladies use stout while nursing, so that their infants “ are never sober from the earliest period of their existence until they have been weaned.” Beginning life under such a regimen, is it any wonder that so large a number of young men, and young women also, develop into drunk¬ ards ? Such a result is only the fruit of the seeds sown in earliest infancy. The ancient Romans were so well aware of this fact that the use of alcoholic drinks was by law prohibited to a Roman mother while an infant was dependent upon her for support. What Does Experience Prove ? — The testimony of many emi¬ nent physicians is that the use of alcohol as a supporter of vitality, a tonic, or a stimulant, is wholly unnecessary. In London, there is a temperance hospital under the charge of Dr. J ames Edmunds, who delivered a very interesting series of lectures on this subject in New York City a year or two since. In this hospital, all alcoholic medicines are excluded “ without incurring any risk or delay in recovery, and with advantage rather than detriment.” The death rate, from the first establishment of the hospital, has been but six per cent, a rate far below that of other hospitals. Of more than three hundred surgical cases, which are generally supposed to espe¬ cially demand alcohol, not a single one proved fatal without it. Other hospitals are following the example of the temperance hos¬ pital, and with equally favorable results. Says Prof. Miller, M. D., of Scotland, “ Alcohol cures nothing.” Dr. Higginbottom said before the British Medical Society, “ I have never known a disease cured by alcohol.” Dr. Johnson, an English physician, says that alcoholic liquors are, “as medicines, wholly unnecessary.” A few years ago, two thousand English physicians publicly ex¬ pressed their disapproval of the use of alcohol as a medicine. AEG UMENTS CONSIDERED. 487 In London alone, three hundred physicians signed a petition for the suppression of the liquor traffic, “ alcoholic drink being, in their opinion, wholly unnecessary for medical purposes.” Prof. L. P. Yandell, a distinguished Southern physician, in a letter from Europe to the Louisville Medical News, wrote as follows of the opinion of English physicians respecting alcohol : — • “ After a very extended intercourse with the profession here, I am inclined to believe that a majority of the strong men consider alcohol harmful as a beverage, and a very large number are very doubtful of its efficacy in disease. Such are. my own views of alcohol.” At a recent meeting of the British Medical Temperance Associa¬ tion, at which many members of the British Medical Association were present, Dr. Ernest Hart, editor of the British Medical Journal, stated that “ the medical profession were nearly all agreed that alcohol was neither a food nor a tonic.” At the present time there exists in England an organization known as the British Medical Temperance Association, which comprises in its ranks many of the ablest medical men in Great Britain. We have treated several hundred cases of all forms of acute and chronic diseases, and have found very little occasion for the use of alcohol. Of over sixty cases of typhoid fever treated in one epidemic, not more than one or two received alcohol or stimulant of any kind, yet all recovered, without any unpleasant after-effects, and without the prolonged convalescence so common after this disease. If brandy, or alcohol in any form, is ever admissible, it is only when its poisonous effects as an irritant may be desirable, just as a dash of cold water, the application of a hot poker to the spine, or of ammonia to the nostrils, may each under some possible circumstances be serviceable in arousing the vital energies from a sudden collapse, and thus preventing death. ARGUMENTS IN FAVOR OF ALCOHOL CONSIDERED. In order to call attention to some other facts of importance, neces¬ sarily omitted in the consideration of the subject thus far, we will devote a few pages to an examination of some of the principal argu¬ ments urged in favor of the use of alcoholic liquors. 1. Alcohol Is Food. — The aristocratic toper, who wishes to give an air of respectability to his vice, will claim that alcohol is a food. He will cite, in proof, instances in which persons have lived for weeks 488 STIMULANTS AND NARCOTICS. by the aid of no other nutriment, taking nothing but alcohol and water. This semblance of argument scarcely needs exposure ; for the most that can be claimed is that it proves merely that persons have lived several weeks while taking only alcohol and water. The fact that individuals have in several instances been known to live from thirty to sixty days while taking only water, shows conclusively that those persons who lived a shorter time on brandy and water lived in spite of the alcohol instead of by the aid of it. A conclusive evi¬ dence that alcohol is not a food is found in the fact that when taken into the system it undergoes no change. It is alcohol in the still, alco¬ hol in the stomach, alcohol in the blood, alcohol in the brain, in the liver, in all the tissues, and alcohol in the breath, in the perspiration, and in all the excretions. In short, alcohol is not used in the body, but leaves it, as it enters, a rank poison. “ I can no more accept them as food than I can chloroform or ether . ’ ’ — Richardson. 2. Alcoholic Beverages Preserve the Body. — Alcohol is a pow¬ erful antiseptic. An apple or the body of an animal placed in the fluid, cannot undergo decomposition. From this, some lovers of the article are very ready to infer that the use of alcohol will prevent de¬ composition of the tissues of the body, and thus tend to its preserva¬ tion. A greater fallacy could not be conceived. Corrosive sublimate, blue vitriol, copperas, and carbolic acid are excellent antiseptics ; but who would think of taking any of these articles for the purpose of prolonging life ? But if alcohol did really hinder the destruction of the tissues, so as to prevent the natural process of disintegration, it would still be very injurious ; for all the processes of life are dependent upon de¬ structive changes of tissue ; and hence, anything which would hinder this process would hinder vital action, would interfere with the life processes which are essential to the manifestation of life. But it can be shown that the evidence upon which the scientific advocates of the use of alcohol base their arguments is quite unsatis¬ factory. They claim to find that the body wastes less while a person is using alcohol than when abstaining, the other conditions being the same. Hence, they tell us alcohol prevents vital changes, and so saves the body from wearing out. With this view they recommend the use of liquor to those who are obliged to undergo any hardship, or to per¬ form any severe physical labor. ARGUMENTS CONSIDERED 489 Let us examine this argument. It is found that the urine and other excretions contain less of the worn-out material of the tissues when a person is using alcohol than when he is abstaining. From this alone it is concluded that alcohol prevents the wearing out or disin¬ tegration of tissue, — a most astonishing conclusion. No one but a man stoutly prejudiced in favor of alcohol would think of forming such a conclusion. A far more rational deduction from the premises would be that the presence of alcohol in the system 'prevents the ex¬ cretory organs from eliminating from the body the dead and poison¬ ous products which result from the wearing out of the tissues. This conclusion would seem to be far more reasonable, since alcohol itself is a poison which is thrown out by the same organs whose proper func¬ tion it is to remove the debris of the tissues. These organs cannot perform more than a certain amount of labor. If most of their activity is expended in eliminating alcohol, of course they can perform less of their proper labor, and so the dead products of disorganization will be left to accumulate in the body and produce a deceptive increase of weight. It is by this means that the drunkard often acquires a bloated appearance. Every one knows that such an accumulation of tissue is not healthy flesh ; yet it is of the same character as that which leads some prejudiced scientists to pronounce in favor of alco¬ holic beverages as a preventive of waste. Surely, such science must be of the kind referred to by the apostle Paul when he spoke of “ science falsely so-called.” If it were any recommendation to alcohol that it diminishes the waste of the tissues, or is supposed to do so, this would be an equally good recommendation for the habitual use of nitric acid and mercury, which Dr. Fyfe of Edinburgh has shown to have the same effect. Again, as already observed elsewhere, Dr. E. Smith and others have proven that alcohol does not diminish the waste of the body, but rather increases it, as is shown by the increased amount of carbonic acid thrown off by the lungs, although the amount of urea eliminated by the kidneys may be less. This, of course, completely upsets the argument used by those who maintain that alcohol is a sort of nega¬ tive food. 3. Alcohol Strengthens the Muscles.— The laborer, the traveler, and the soldier use alcohol under the delusion that it strengthens. When fatigued, the laborer takes a glass of grog and feels better, or thinks he does. He imagines himself stronger. His increased strength, however, is wholly a matter of the imagination. 41)0 STIMULANTS AND NARCOTICS. The use of alcohol makes a man feel stronger, — makes him believe that he can do more work, endure more fatigue and hardship, and withstand a greater degree of cold than he could do without it ; but when an actual trial is made, it soon becomes apparent that the ability is lacking. Feeling and doing are two wholly different things ; and here is where alcohol is so deceptive. It is a narcotic, and paralyzes the nerves so that they lose their normal sensibility. The weary man takes a glass of brandy, and continues his toil, — not because he has been strengthened, not because his vital forces have been re-inforced, but because he no longer knows that he is tired. Weariness is an ap¬ peal for rest on the part of the tissues. They have become worn and broken by action, and they require time to repair themselves. Alco¬ hol has the same effect upon the nerves which control the building up of the body that chloroform has upon the nerves of general sensi¬ bility, and it allays the sense of weariness in the same way that chloro¬ form allays pain during a surgical operation, — by paralysis. A person whose hand has been rendered insensible to pain by intense cold may place his fingers in the fire without suffering at the time, but he is not thereby prevented from being burned, any more than though his sen¬ sibility was unimpaired ; and the effects of the destructive action of heat will ultimately become painfully apparent. When a man has labored until his tissues are so broken down that they demand time for reconstruction, alcohol will so paralyze his sen¬ sibilities that he may continue laboring for a time, but he does so at a terrible cost ; for he is all the time continuing the process of breaking down his tissues beyond the point at which nature warned him to de¬ sist. Not infrequently this reckless expenditure is continued so long that the life forces become so completely exhausted that the individual becomes a victim of delirium tremens, or perhaps dies from exhaustion. Numerous experiments have shown that alcohol decreases muscular strength. Says Dr. Brinton, “ The smallest quantity takes somewhat from the strength of the muscles.” Says Dr. Edmunds, of London, “ A stimulant is that which gets strength out of a man.” Said Prof. Willard Parker, M. D., of New York, “It has been proved that when taken into the system it diminishes the tempera¬ ture, lessens the strength, and by about forty per cent shortens human life.” 4. Alcohol Warms the Body.— The sensation of warmth pro¬ duced by taking a glass of wine or brandy is delusive. The circula- ARGUMENTS CONSIDERED. 491 tion is unbalanced, and for a few moments there is a seeming increase of heat ; but the thermometer shows that the temperature is lessened. Says Dr. Parkes, the eminent English sanitarian, “ All observers con¬ demn the use of spirits, and even of wine or beer, as a preventive against cold.’ The names of Dr. King, Dr. Kane, Captain Kennedy, and Dr. Hayes, may be cited as holding to this opinion. In the last expedition in search of Sir John Franklin, the whole crew were tee¬ totalers. Prof. Janeway, M. D., professor of materia medica in Bellevue Med¬ ical College, stated in a lecture before his class that alcohol does not assist those who use it to endure cold. In proof of the assertion, he re¬ lated the following incident, which was given to him by the first gen¬ tleman mentioned in the account : — A gentleman was appointed by the government to go on a survey in the Eastern States in the depth of a severe winter. He chose for his assistants men who were total abstainers. At the same time, another party set out upon the same business, the members of which were ad¬ dicted to the use of whisky. Only one of the first party gave out, while nearly every one of the whisky-drinkers succumbed to the influ¬ ence of cold. “ Plenty of food, and sound digestion, are the best sources of heat.” “ I am quite satisfied that spirituous liquors, though they give a tempo¬ rary stimulus, diminish the power of resisting cold.” — Sir John Rich¬ ardson. a When a continuance of exertion or endurance is called for, spirit does harm ; for you are colder or more fatigued a quarter of an hour after [taking] it than you would have been without it.” — Dr. Hooker , ' physician of the Arctic expedition under Sir John Ross. Prof. Miller states that the Russian military authorities “ interdict its use absolutely in the army, when troops are about to move under extreme cold ; part of the duty of the corporals being to smell carefully the breath of each man on the morning parade, and to turn back from the march those who have indulged in spirits, it having been found that such men are peculiarly subject to be frost-bitten and otherwise injured.” “ The Hudson Bay Company have for many years entirely excluded spirits from the fur countries to the north, over which they have exclu¬ sive control, ‘to the great improvement,’ as Sir John Richardson states, ‘ of the health and morals of their Canadian servants, and of the Indian tribes.’ ” — Dr. Carpenter. 492 STIMULANTS AND NARCOTICS. 5. Alcohol Protects against Excessive Heat.— The advocates of drinking, like the man in the fable, “ blow both hot and cold,” in their arguments. Thev love the beverage, and so it must be useful in some way. Dr. Parkes says on this point, “ Not only is heat less well borne, but insolation (sunstroke) is predisposed to.” “ The common no¬ tion that some form of alcoholic beverage is necessary in tropical cli¬ mates is, I firmly believe, a mischievous delusion.” His statements are supported by all the best authorities on tropical diseases, Dr. Carpenter and others. Said Prof. John Bell, M. D., an eminent medical author, “ They who drink nothing but water have been found to be more enduring of fatigue and great labor, and of hardships and exposures in every extreme of climate and season, than they who use alcoholic beverages. The com¬ parisons have been made in almost every conceivable manner (seldom, it is true, designedly), and with the result just announced. Men who have to carry on laborious occupations at a high temperature, as in iron- foundries, gas-works, sugar-houses, etc., find that the use of alcoholic liquors, while they are so employed, is decidedly prejudicial to them. Of twelve workmen— smiths in the dock-yard at Portsmouth, En¬ gland — who tried the experiment for a week, six drank nothing but waiter, the other six took the usual allowance of beer. After the first day, the water-drinkers complained less of fatigue than the others, and after each successive day the advantage was on the side of the abstain¬ ers, until the conclusion of the week, when the water-drinkers declared that they never felt so fresh in their lives as they had done during this period.” According to Sir James McGregor, quoted by Dr. Bell, the Anglo- Indian army was never so healthy as when in Upper Egypt, where no ardent spirits were supplied to the troops on account of the difficulties of transportation. The soldiers were often exercised in the sun, the heat of which was so great that the thermometer indicated 118° F. in the shade. It has been observed that among English soldiers in India those who are strict teetotalers endure long marches under exposure to a tropical sun much better than those addicted to the use of liquor. During the hot season in this country it has been found that by far the larger share of all the cases of sun-stroke which occur are of intem¬ perate persons. Total abstainers have little to fear from sun-stroke. 6. Alcohol Stimulates. — So, then, do opium, strychnia, and prussic acid stimulate. What is a stimulant? “Stimulant” is only another AEG UMENTS CONSIDERED. 4'Jo name for poison. Stimulation means poisoning. When alcohol, or any other one of a hundred poisons which might be mentioned, is taken into the body, every vital organ sets to work to get it out. The liver filters it out in the bile ; the lungs pour out volumes of it in the form of a vapor, making a drunkard’s breath smell like a distillery; the skin pours it out as sweat ; the kidneys do their part in expelling the vile drug ; and all the time the heart pumps away with violence to hasten the departure of the intruder. This great commotion in the vital econ¬ omy is called “stimulation.” These are the first effects of alcohol, or the effects of small doses, — such effects as the moderate drinker feels. The later effects, and those which result from larger doses, are depressing. The excitement is followed by a corresponding degree of depression, or partial paralysis, since the drug supplies no force in return for that which it expends. Many of the ablest physicians pronounce alcohol a narcotic. If alcohol is a stimulant, that fact is one of the best arguments against its use. Says Sir B. Brodie, “ Stimulants do not create nerve power.” 7. Alcoholic Drinks Protect the System against Disease. — One finds an excuse for the use of liquor in small or great quantities in the theory that it will fortify his system against the ravages of small¬ pox or cholera. Another takes liberal doses of brandy to “ keep off the chills.” Another keeps his system saturated with alcohol so that he will not take cold. Any one of these diseases, or almost any other, would be infinitely less harmful than alcohol itself, even if the opinion were true, that alcohol is a preventive ; but alcohol is not a preventive of disease, according to the experience of the most reliable observers. Dr. Parkes, Sir John Hall, Inspector General of the English army, Dr. Carpenter, Dr. Mann, Henry Martin, and others of equal eminence, all concur in this opinion. Indeed, the most indubitable evidence can be cited to prove that al¬ cohol is directly the cause of a vast amount of disease, instead of being, as many suppose, a preventive. If alcohol were a preventive of disease, then those who use it ought to be the most healthful ; but we find the contrary to be the case. The liquor-drinker, instead of living longer than the teetotaler, as he ought to do if this theory were true, lives, on an average, after reaching adult age, only one-fifth as long as the ab¬ stainer, as shown by life-insurance statistics. 8, Alcohol Aids Digestion. — The moderate drinker takes his morning dram to fortify his stomach for the reception of his breakfast. 494 STIMULANTS AND NARCOTICS. Immediately after breakfast he must have another glass to assist di¬ gestion. But how does alcohol assist digestion ? Not by dissolving the food, for its effect is to harden tissues. It does not render the gas¬ tric juice more efficient, for it destroys it and causes its active element, pepsin, to be deposited as a white powder. In dogs to which alcohol was given with food, it was found that the process of digestion had not begun, twelve hours after eating. The stomach is obliged to re¬ move all the alcohol before digestion can begin. This, then, is a mon¬ strous fallacy. 9. Alcohol Is Made from Grain. — “ But,” says one, “ alcohol is made from grain, and if it is so very bad, why should not the grain be injurious also ? There is a little poison in everything, any way.” Alcohol is made from grain, but it is not found in it. Smoke is made from wood, yet there is no smoke in wood ; it is made by the destruction of the latter. Alcohol is made by the destruction of fruits and grains. It is an absurd popular notion that there is, necessarily, poison in everything. In these days of wholesale adulteration it is often diffi¬ cult to obtain food unmixed with poisonous products ; but nature does not serve us so badly. Poison is not essential to life. 10. Whisky Does not Hurt Me . — The opium smoker, the absin¬ the taker, the arsenic eater, all use the same argument, yet each falls a victim to his vice. You do not know what alcohol is c[oing for you. “Wine is a mocker [deceiver].” You cannot see its depredations. Your blunted sensibilities cannot feel its ravages. Your friends see its influence. Your wife notes it and mourns over it. You can your¬ self see it in others. Are your tissues different from those of every other man ? Are they made of iron that they cannot be destroyed ? Is the alcohol you drink different from all other alcohol ? No ; vour good sense tells you, No. Then reform before it is too late. 11. Pure Liquor Is not Bad.— “If we only had such pure liquor as they used to make, it would not be so very bad,” says one. “ Only take a little of my wine ; I made it myself, and it cannot hurt any one,” says the good housewife. These are two mischievous errors. Alcohol is the worst poison found in liquor. No drug added by adulteration is so bad as the fiery liquid itself. Pure liquor is simply pure poison. Alcohol is always the same, and its effects are always identical, whether it is found in the whisky barrel, or the cider barrel; in rum, brandy, lager-beer, AEG UMENTS CONSIDERED. 40;* home-made wine, or “ temperance bitters.” Alcohol is the horrid fiend we are fighting, no matter under what guise it comes. 12. Moderate Drinking not Harmful. — Every man, even the drunkard himself, admits that liquor in excess is injurious ; but a large and very respectable class claim that it is an evil only in excess, and is a harmless luxury, if nothing more, in moderate quantities. This, too, is an error which has proved fatal to thousands. A small dram soon grows to be a large one ; claret is exchanged for grog or toddy ; and so, by degrees, the moderate drinker becomes a drunkard, the first “ small drop ” engendering a love for succeeding larger doses. It is not necessary that a man should be dead drunk to be intoxi¬ cated. Intoxication is derived from a Latin word meaning poison, and means, literally, a condition of poisoning. Alcohol is a poison. If a man takes it into his system, he is poisoned, or intoxicated, in proportion to the amount taken. Moderate drinking produces a disease well known to physicians as chronic alcoholism. It is especially dangerous to the old, as it is one of the most powerful predisposing and exciting causes of apoplexy, as well as of numerous other diseases. 13. Doctors Recommend Wine and Brandy. — It is a lamentable fact that a large class of physicians use alcohol in their practice in a most reckless manner. The result is seen in hundreds of drunken sots who haunt saloons and groggeries. That the free use of alcohol is wholly unnecessary has been already shown. Id. Scientific Men Recommend the Use of Alcohol. — This, too, is a deplorable fact ; for it is a sad spectacle when science stoops to cater to the demands of morbid appetites and vices. It is a signifi¬ cant fact that those scientific authorities who recommend the use of alcohol are themselves addicted to its use. It is not an unjust infer¬ ence that their judgment, in this case, is biased by their appetite. But there are a great many of the most eminent scientists who are the strongest advocates of total abstinence. Among them are Dr. W. B. Carpenter, Dr. Parkes, Dr. Richardson, Dr. Parker, and Sir John Hall. “ If alcohol were unknown, half the sin and a large part of the poverty and unhappiness would disappear from the world. Dr. Parkes, Practical Hygiene, p. 242. “ There is, of course, no doubt that wine is unnecessary as an arti¬ cle of diet.” — lb., p. 241. 496 STIMULANTS AND NARCOTICS. A long list of names of eminent scientists and physicians might be presented against alcohol as a beverage, and a very respectable list against its common use as a medicine. There is no doubt that many popular medical works which have recommended alcohol as a remedy for almost every ill, have done much toward creating an incorrect popular opinion on this subject; and it is the duty of every intelligent physician, as well as all others who are informed on the subject, to do what he can to correct this pernicious error. 15. All Nations Use Stimulants. — Some will argue from the fact that the use of liquor of some kind is almost universal, that the appe¬ tite for it is a natural one. Admitting that inheritance may have made it such, the argument is still worthless ; for what nation is there among whom lying, stealing, and other crimes and vices do not also exist ? If intemperance is a universal evil, the fact should be most deeply deplored, instead of being made an excuse for perpetuating the vice. But intemperance is not universal. Until taught the use of alco¬ hol by white men, the North American Indians were wholly unac¬ quainted with the fiery beverage which they have appropriately named “ fire water.” And the introduction of liquor among these savages has done more toward their extermination than any other cause. Many other barbarous tribes are still in happy ignorance of this enticing poison. Again, the appetite for fermented drinks is not a natural one. Offer an infant brandy ; it is repulsed at once, as it should be. No beast naturally loves alcohol, though there are several animals which, like man, may be taught to love liquor and demand it as imperiously as any old toper. The hog is an animal of this kind. The resem¬ blance of man to this animal, in this respect, is not flattering, at least. Dr. Floyer, a writer in the early portion of last century, relates the case of a brewer’s dog which learned to like beer and ale, and formed the habit of licking ale and yeast from the brewer’s trough. After a few years he began to suffer greatly from gout, his feet and limbs swelling prodigiously. The drunken dog finally died, as thou¬ sands of other drunkards have, of dropsy. Even though an artificial appetite has in some cases been created, this fact does not change the relation of alcohol to the system in the least. Alcohol is a poison still ; and the system will treat it as such, in spite of an inherited or an acquired appetite for it. ARGUMENTS CONSIDERED. 497 16. The Use and Sale of Alcoholic Liquors Is a Source of Great Revenue to the Government.— Says the liquor-dealer, “The manufacture and sale of alcoholic drinks gives employment to more than 500,000 men. It furnishes a market for more than 40,000,000 bushels of grain each year, and pays to the government an annual tax of $60,000,000, or about two-fifths of the whole revenue of the country.” Such arguments are actually urged by the dram-sellers and their in¬ fatuated customers. What a damage to the government would be the loss of $60,000,000 of revenue ! and what a pity that 500,000 poor laborers should be thrown out of employment ! Ah, yes ; and what a pity that 40,000,000 bushels of grain, equivalent to 600,000,000 four- pound loaves of bread, should be wasted — worse than wasted, manufact¬ ured into poison ! The same liquor which brings to the government a revenue of $60,000,000 makes 800,000 paupers, who require for their maintenance $100,000,000. There is very little profit in this, surely. The cost of crime resulting from drink is still greater. The expense of caring for 30,000 idiots and lunatics must also be charged to alcohol. Where, then, are the profits ? W e have said nothing of the loss result¬ ing from the unproductive labor of those employed by the liquor bus¬ iness, or from idleness, disease, and death occasioned by drink, which ag¬ gregate an enormous sum. 17. The Moderate Use of Wine is Necessary to Maintain Nervous Activity in Old Age. — Many, even of those who profess to be instructors of the people in the laws of health, advocate the use of wine in old age, on the ground that age renders the system somewhat slug¬ gish in its activities, and hence a little stimulus is needed to maintain its functions, and especially nervous activity. A consideration of this argument will show that the use of alcohol is not only unnecessary in old age, but absolutely hazardous. Why are the bodily functions less active in old age than in youth? Why is the mind less brilliant? Because the organs of the body have become worn and disabled by long usage and imperfect repair. The tissues are not kept intact by assimilation. The reason why they are less active, then, is that they are less qualified to act. They are incapable of that vigor¬ ous action which they sustained in youth and middle age. This decreased activity is an admirable provision of nature for the prolongation of life to the utmost limit. The waste of tissue depends upon its activity ; the more action, the more waste and wear, the sooner 32 498 STIMULANTS AND NARCOTICS. worn out. Using alcohol produces an increased activity, but does not increase the capability of the system to sustain action. In other words, it tears down tissue, but does not build it up. It interferes with the re¬ pair of tissues. The increased vigor seemingly imparted by alcohol, therefore, is dangerous, rather than desirable. If alcohol enables a man to live faster, it shortens his existence by so doing. Again, alcohol, even in moderate quantities, produces a peculiar de¬ generation of the walls of the blood-vessels, by which they become weakened, the muscular tissue composing the small vessels being re¬ placed by particles of fat or carbonate of lime. This kind of degenera¬ tion is also a frequent incident of old age, even in those who are not spirit -drinkers, and is especially liable to occur in the small arteries of the brain. The use of alcohol not only facilitates this morbid process, but adds to the danger which is always present with it under the most favorable circumstances. When the arteries are thus weakened, a little extra supply of blood in the brain, a “ rush of blood to the head,” will often occasion rupture of some one of them, and apoplexy, with paralysis or immediate death, is the result. Alcohol, even in very small quantity, produces congestion of the brain, and thus renders an aged person doubly liable to death from apoplexy. Are we not j ustified. then, in the position that alcohol is not only less desii'able for the old than for the young, but is far more dangerous ? 18. Alcohol Drives away Dull Care.— It will not be disputed that alcohol will dissipate cares, and pains, and sorrows. It makes a poor, homeless, friendless, poverty-stricken wretch feel as rich as a king. It makes the doomed murderer forget that he is soon to swinsr into eternity from the gallows. It makes the fallen outcast from society forget her shame. In short, it makes the user momentarily oblivious to all that is unpleasant in life. But the release thus obtained is only for a moment, and it is inevi¬ tably succeeded by a return of the same old burden, rendered more gall¬ ing and onerous by the stings of conscience and the goadings of remorse. When a man’s brain is so benumbed that he does not know his real condition, and loses sight of the realities of life, he is likewise incapable of appreciating any of those higher experiences and sentiments which constitute the highest enjoyments, the true realities of life. Only gross and sensual pleasures can be experienced when the mind is befogged by alcohol. A EG U ME NTS CONSIDERED. 499 19. Alcohol Increases Mental Power.— Thousands of editors, lawyers, students, authors, and even clergymen, keep beside their mid¬ night lamps a bottle of wine or brandy, and consider one as indispensa¬ ble as the other. They imagine that with the frequent drams they quaff from that green bottle, they imbibe an increase of mental vigor. Thousands of lecturers, orators, and ministers, sip a glass of sparkling poison just before they step upon the platform. The first imagines that alcohol is necessary to enliven his energies and sharpen his memory. The second relies upon alcohol to burnish his eloquence. The third de¬ pends upon the poisonous beverage to quicken his pious zeal, intensify his fervor, and lend him inspiration for the duties of his office. We might justly dwell upon the absurdity of such practices, and well question the efficiency of a gospel shrouded with the fumes of al¬ cohol ; but we will only quote the words of Dr. James Edmunds, of London, Eng. He says, in speaking of the narcotic influence of alcohol: — “ That is the effect when a minister, who cannot preach without a glass of wine, has a glass in him. He finds his tongue will run on a little faster than his brains would be able to drive it if he had not got the alcohol in him. I submit to you broadly that if you take a man with a single glass of wine or spirits in him— if you test that man’s mental accuracy and real debating power, you will find that the man who has spirit in him won’t do it as well as the man who does not use it.” 20. Alcohol Is a Good Medicine ; and if it Will Make a Man Well when Sick, Will it not Keep him Well ?■ — Alcohol is not a good medicine, as elsewhere shown. It is a poison, always, under all circumstances. But if it were a medicine, this would certainly be reason enough for discarding it ; for a medicine is supposed to be a substance peculiarly adapted to meet the demands of the system when in a state of disease. Almost any one of those substances popularly known as medicines will make a man sick if used habitually. Dr. Gully pertinently remarks, “ Healthy men, and men with chronic disease, do not require medicinal means every day after dinner. Yet there are men silly enough not only to take a nauseous pill of drugs before dinner, but this more pleasant but equally deleterious draught of physic [wine] after dinner. Strange infatuation ! 21. The Bible Sanctions the Use of Wine. — At the present time there is a powerful party who claim that the use of fermented, or in- 500 STIMULANTS AND NARCOTICS. toxicating liquors is permitted and even sanctioned by the Bible. This party is headed by a few eminent scholars and clergymen, who are chiefly supported by a promiscuous throng of rich rumsellers, re¬ spectable moderate drinkers, and gutter drunkards. The Bible has been quoted to sustain polygamy, slavery, and other evil institutions, as well as intemperance. Rightly understood, it sup¬ ports none of these evils. If it can be proven that the Bible favors the use of intoxicating drinks in any degree, then there is placed in the hands of the infidel a most powerful weapon with which to attack the authenticity and sa¬ credness of the Scriptures. If, on the other hand, it can be shown that there is no such conflict between science and common sense, and in¬ spiration, then the difficulty vanishes. A careful examination of the subject will convince any candid man that the support which the ad¬ vocates of the use of liquor claim to derive from the Bible is wholly imaginary ; and that the use which is made of the Scriptures in de¬ fense of intemperance is a most flagrant perversion of the language and import of inspiration. Inspiration, true science, and sound common sense always agree. Any apparent conflict arises either from a misunderstanding of the meaning of the language employed, or from an imperfect knowledge of the scientific facts supposed to necessitate a disagreement. Science says, distinctly and unequivocally, All fermented drinks contain alco¬ hol ; alcohol is a poison under all circumstances and in all doses. The decision of science is sustained by that of reason ; for common sense teaches that a substance with properties like those possessed by alcohol can be nothing else than poisonous. If it is true that the Bible teaches that alcohol — in the form of wine, or otherwise — is good and harmless, then it will be made to appear that inspiration is less wise than reason and science ; that man, the creature, has outstripped the Creator in knowledge. Such a conclusion, though correctly drawn from the premises, is too absurd for belief by one who has a modicum of faith in inspiration, and its manifest falsity would seem to be sufficient to fully expose the weakness of those who would make the Bible responsible for intem¬ perance. The utter worthlessness of all arguments in favor of the use of alcoholic drinks, founded on the Bible, becomes still more apparent by a careful examination of the character of the wines mentioned in the Scriptures, and a consideration in detail of the texts which are claimed to be favorable to the use of alcoholic liquors. SC RIP TUB A L DISTINCTIONS. 501 Two Kinds of Wine Recognized in the Bible. — It is undoubt¬ edly true that intoxicating liquors are mentioned in the Bible ; and it is equally true that a kind of liquor or wine is recognized and often mentioned which is not intoxicating. Ancient historians preserve the same distinction, making frequent reference to intoxicating wine and its effects, and also to unintoxicating wine and its wholesome proper¬ ties. Unintoxicating Wine. — The intoxicating property of wine is due to the alcohol which it contains. Wine which contains no alcohol is unintoxicating. Alcohol is produced only by fermentation. Wine ■which has not undergone fermentation, then, is unintoxicating, since it contains no alcohol. All that is required to preserve wine free from alcohol, and thus from intoxicating properties, is to prevent fer¬ mentation. That the ancients were acquainted with several modes of preventing fermentation, is clearly shown by reference to history. Intoxicating Wine. — As already stated, the intoxicating element of wine is alcohol, which is produced by the decomposition of sugar in the process of fermentation. Alcohol can be made from any juice which contains sugar. The ancients made intoxicating drinks from o o millet, dates, beans, palm juice, pears, figs, pomegranates, and other fruits, besides the grape. These liquors were known to the Jews, and are frequently referred to in the Scriptures. In Prov. 23 : 31, we have a striking reference to the fermentation of wine, as follows, according to Dr. Kitto’s translation : “ Look not thou upon the wine when it is turbid, when it giveth its bubble in the cup, when it moveth itself up¬ right.” Scriptural Distinctions of Wines. — In the English version of the Scriptures, the distinctions made in the original are often obscured or wholly lost. This is especially true in the present instance. In the Hebrew, the language in which the Old Testament was written, different kinds of wine are indicated by different words, which are all rendered in the English translation by the one word wine. The prin¬ cipal words thus employed are f-, yayin, “W, shekar, and c/n'^, tirosh. Yayin, according to Biblical critics, refers to the juice of the grape in any form. It might be sweet or sour, fermented or unfermented. Shekar, or shechar, was the term applied to any sweet juice derived from any other source besides the grape. It is sometimes translated honey. It usually refers to the juice of the palm-tree or of its fruit, the date ; and, like yayin, it included the fermented as well as the un¬ fermented condition of the juice. 502 STIMULANTS AND NARCOTICS. Tirosh was applied to the ripe fruit of the vine, and to the fresh juice of the grape before fermentation had begun. It is often trans¬ lated “ new wine.” In brief, then, yayin means fermented or unfermented wine or juice of grapes; shekar means fermented or unfermented wine or juice of the palm-tree, of dates or other sweet fruit. Tirosh means the sweet, unfermented juice of the grape, or new wine. The Hebrews used the term yayin for wine made from grapes, in any of its stages, just as we apply the term cider to the fresh juice of the apple, or to the same juice after it has fermented or become “hard” by age. The Greek oivoc, oinos, corresponds exactly with the Hebrew yayin. The foregoing is certainly sufficient to show, beyond all chance for reasonable doubt, that there are two kinds of wine recognized in the Bible, one of which was sweet, unfermented, and unintoxicating, and the other fermented and intoxicating. The same term is often used for both kinds. If, then, we find the Bible in some instances speaking of wine in terms of commendation, and in others condemning it in the most forcible manner, would it not be most reasonable to suppose that in those cases in which wine is commended, the unfermented kind is referred to ? and in those in which it is condemned, that which has un¬ dergone fermentation is meant ? Any one who has confidence in the inspired character of the Scriptures will have no hesitancy in answer¬ ing in the affirmative. The Causes of Intemperance. — We have not space to devote to the subject sufficient to allow us to point out more than a few of the more powerful influences which in our opinion lead to the encourage¬ ment and perpetuation of one of the most potent evils of the age. The most confirmed and irreclaimable drunkards are those who have inherited the appetite from ancestors who drank. There are many such. They are really less responsible for their condition than are those whose vices have entailed it upon them. Many instances are known in which the tendency to drink extended to the fifth generation from a drinking ancestor. Probably this is the most active cause of the great and unabating increase of intemperance. Drunkard’s sons become drunkards through inheritance, and transmit the propensity to their children, stamping it still more deeply upon their depraved organizations. The use of alcohol in cookery has clone not a little to cultivate a love TEA AND COFFEE ENCOURAGE DRUNKENNESS. 503 for the burning beverage. Wine and brandy sauces, and other prepara¬ tions containing alcohol, early excite and form a love for alcoholic drink in children whose natural tastes would discard it at once. It is not at all uncommon to find alcohol taken in this form, even by people who consider themselves strict teetotalers. Still another charge of far more universal application must be laid at the door of the cook, though the ignorance of the latter may cancel part of the responsibility. We refer to the general and excessive use of stimulating and irritating condiments in the preparation of food. Pep¬ per, spices, and large quantities of salt and most other condiments, have an unmistakable influence in creating and exciting a love for stimulat¬ ing foods and drinks, and thus ultimately lead toward intemperance. The moderate use of liquor is the stepping-stone to greater excesses. All drunkards are at first moderate drinkers. Were there no moderate drinkers, there would soon be no drunkards. No man sets out in the drunkard’s career with the expectation and determination of becoming an inebriate. It may be justly said that moderate drinkers are fresh recruits for the ranks of intemperance. Tea and Coffee Encourage Drunkenness.— This statement will doubtless startle those who have been taught to believe that there is no evil in “ the cup that cheers and not inebriates ; ” but we are prepared to show that the influence of the use of these poisons (for such they are) directly tends to encourage drinking stronger stimulants, though our present space will not allow us to enter into a discussion of the subject. Tobacco-using and drunkenness go hand in hand. Nearly, if not quite, every drunkard chews or smokes. The great majority of drunk¬ ards became addicted to the use of tobacco first. Thus they learned to demand a stimulus of some kind. The feverish heat produced by tobacco required quenching, and liquor was resorted to. The white man gave the Indian rum, and the latter gave him tobacco in return. The ex¬ change was a bad bargain for both. Either is bad enough alone ; but rum and tobacco together are blasting the human race like a simoon from the heart of hell. Thousands of men, and women too, have acquired an appetite for alcohol through a doctor’s prescription. An unwise physician gave ale, beer, wine, or brandy, as a “ tonic,” “ to improve digestion,” “ to strengthen the system,” “ to counteract debility,” or for some similar reason. The patient thus acquired a love for the stimulation of alcohol, and soon came to regard it a necessity, and took the duty of prescribing 504 STIMULANTS AND NARCOTICS. into his own hands. In a few years he became a drunken sot, and died a drunkard’s death. Ambition to excel on some particular occasion, or a desire to compel nature to forego rest beyond reasonable limits, has led many to take “ an occasional drop,” to their final ruin. The “ fine exhilaration,” the “ lively play of the imagination,” which accompanies slight stimulation, has led captive thousands of poets, authors, orators, statesmen, and even clergymen. Poverty, trouble, grief, disappointment, bad example, and other minor causes too numerous to mention, have their influence in the production of the omnipresent vice, intemperance. The Cure of Intemperance. — The only cure for a drunkard is total abstinence. A person who has once been greatly addicted to the use of alcohol cannot use it in moderation. A person who is suffering from an}? of the functional diseases induced by alcohol must relinquish all stimulants if he would recover. Substitutes in the shape of tobacco, strong tea and coffee, even of soda-water, are dangerous. Tobacco produces a desire for liquor in one who has been accustomed to drink. Tea and coffee have similar effects, though in much less degree. The drinking of large quantities of fluid of any sort is injurious, as it produces a relaxed state of the stomach which causes a craving for stimulus. The “ cin¬ chona cure ” of the appetite for liquor is worthless. The only plan which affords a way of escape from the haunting clamors of appetite in a per¬ son trying to reform is that proposed by Mr. Napier, who a few years ago read before a learned society in England a paper giving an account of the cure of a large number of cases of drunkenness by the adoption of a vegetarian diet. The great chemist, Prof. Liebig, observed, more than twenty years ago, that people who used only vegetable food did not take wine. Becoming acquainted with this fact, Mr. Napier made a practical application of it, with the result already stated. The following is a brief report of a few of his cases : — “ An analytical chemist, aged thirty -two, who was given to intem¬ perance, on having his attention called to Liebig’s statement, was in¬ duced to adopt a vegetarian diet, and before six weeks he was a total abstainer. A lady of independent means, a clergyman, a girl of nine¬ teen, a man and his wife and sister (all over forty years of age), a bed¬ ridden gentleman (cured in thirty-six days), a captain in the merchant service, a half -pay officer, a clergyman and his wife, were all cured bv a diet mainly farinaceous [vegetable]. Two sisters, members of a family noted for intemperance, were cured in about a year. A clerk who had THE CURE OF INTEMPERANCE. 505 lost several situations because of intemperance was cured by vegeta¬ rianism and taken back at an increased salary. A governess aged forty, two military pensioners, a man of sixty, and three old sailors, were per¬ manently cured in a few months.” Beans, peas, rice, and highly glutinous bread (graham bread), were observed to be of special value as articles of diet. ‘This testimony is a powerful one in support of the position that the use of animal food is in some degree favorable to intemperance, and may perhaps be a remote cause of that vice in many cases. Both before and since seeing the re¬ port of Mr. Napier’s experiments, personal observation has convinced us that the appetite for liquor is much less in a person addicted to its use while subsisting upon a vegetable diet than when using meat freely. We have also observed that those accustomed to use both alcohol and tobacco are rarely able to abandon one without the other. We might relate numerous cases which have occurred in our own practice in which we have succeeded in reforming inebriates when all other means had failed by enforcing a farinaceous or vegetable diet. There can be no doubt but that the effect of stimulating food of all kinds is in the high¬ est degree conducive to a love for stimulating drinks and for tobacco and other narcotics. i 50 G STIMULANTS AND NARCOTICS. TOBACCO AND TOBACCO-USING. Origin of the Habit. — Four centuries ago, tobacco was unknown in civilized lands, its use being confined to the few savages who in¬ habited the then undiscovered American continent. In the month of Novem¬ ber, 1492, when Columbus discovered the island of Cu¬ ba, he sent two sailors to ex¬ plore it, who reported, when they returned, among many other strange and curious dis¬ coveries, that the natives carried with them lighted fire-brands, and puffed smoke from their mouths and noses, which they supposed to be the way the savages had of perfuming themselves. They afterward declared that they “ saw the naked savages twist large leaves together, and smoke like devils.” To civilized human beings this was the first sight Gf the vile habit which has become so common that every city, town, and village is actually perfumed, or more properly fouled, with the vile stench of the poisonous weed. The impression made upon the unsophisticated Europeans was evidently not greatly in favor of the custom, since they compared the smoking Indians to devils. Tobacco-using, together with the implements of its use and all the different modes of taking it, originated wholly with the heathen bar¬ barians who roamed like wild beasts over the plains and through the dense forests of this continent four centuries ago. Civilized men have made no improvements or discoveries of any account in connec¬ tion with its use ; they have simply followed the example of those THE ORIGIN OF THE HABIT. 507 naked savages whom the discoverers of America saw chewiner, snuff- ing, and smoking “like devils” almost four hundred years ago. It is evident, then, that tobacco-using is a barbarous custom in the fullest sense. As to how savages learned the use of the weed, history does not give us any hint ; but the fact that pipes and snuff-taking tubes are found in their most ancient burial mounds, which are often sur¬ mounted by huge trees that must have required many centuries for their growth, is evidence of its great antiquity. Originating with the wild barbarians of America, the smoking habit was after some years introduced into Europe, and receiving the sanction of physicians who just at that time chiefly occupied them¬ selves in searching for some new nauseous compound with which to experiment upon the lives of their patients, it was rapidly adopted. It must not be supposed, however, that the world was conquered by this most pernicious and tyrannical of vices without a struggle. The good, the wise, and the prudent, everywhere opposed. In most instances, kings and others in authority placed every obstacle in the way of its introduction and propagation, and even imposed severe penalties upon those who used the weed. In Russia, the use of tobacco was prohibited under the penalty of the bastinado (a severe whipping) for the first offense, cutting off the nose for the second, and loss of life for the third. History gives ac¬ count of several persons who were subjected to punishment for a second offense, their noses being amputated in public. Pope Innocent XII. issued a bull of excommunication against all who used tobacco in any form in church. Many years afterward, however, the bull was revoked by Pope Benedict, who was himself an immoderate user of tobacco. In Persia, the laws against tobacco-using were so stringent that the devotees of the weed were obliged to flee to the mountains, where they preferred to wander in exile among the rocks and caves with liberty to use their fascinating drug, rather than dwell in the peace and purity of home without it. In Switzerland, all users of the weed were punished as criminals. Punishment was inflicted upon a man in that country for smoking, so late as in the last century. The opposition to the use of tobacco was not confined to the Old World. The governors of the American colonies followed the example of King James I. of England, in many instances, issuing edicts against its use, and placing every obstacle in the way of its introduction. 508 STIMULANTS AND NARCOTICS. The old “ blue laws ” of Connecticut and of several other States con¬ tained restrictions of its use of a most strenuous character. In the city of Boston a law against smoking still exists ; and less than a dozen years ago a workman was arrested on the public streets for the offense, and was fined in accordance with the law. By degrees, the rulers who opposed the introduction and use of to¬ bacco themselves became devotees of the weed, so that their opposi¬ tion was withdrawn. Being thus without restraint, the evil habit rapidly spread throughout all civilized lands, enslaving alike all classes of people, from the ignorant peasant to the king upon the throne. The history of tobacco-using furnishes a most striking illustration of the readiness of human nature to seize upon anything which promises gratification to the senses, no matter how disgusting, how pernicious, or how fatal in its ultimate consequences. The history of the world affords no other example of a vice which spread so rapidly and fastened itself so securely upon its victims. The Nature of Tobacco. — Chemists, botanists, and physicians unite in pronouncing tobacco one of the most deadly poisons known. No other poison, with the exception of prussic acid, will cause death so quickly, only three or four minutes being required for a fatal dose to produce its full effect. It belongs to a class of plants known as the volanacece, which includes the most poisonous of all species of plants, among which are henbane and belladonna. There are more than forty distinct varieties of the plant, all of which pos¬ sess the same general properties, though varying in the degree of poisonous character. The active principle of tobacco, that is, that to which its narcotic and poisonous properties are due, is nicotine, a heavy, oily substance which may be separated from the dried leaf of the plant by distilla¬ tion or infusion. The proportion of nicotine varies from two to eight per cent, Kentucky and Virginia tobacco usually containing six or seven per cent. A pound of tobacco contains, on an average, three hundred and eighty grains of this deadly poison, of which one-tenth of a grain will kill a dog in three minutes. A case is on record in which a man was killed in thirty seconds by this poison. The poison contained in a single pound of tobacco is sufficient to kill three hundred men if taken in such a way as to secure its full effect. A single cigar contains poison enough to extinguish two hu¬ man lives if taken at once. POISONOUS NATURE OF TOBACCO. 509 The essential oil has been used for homicidal purposes. Nearly thirty years ago it was employed by the Count Bocarmd to murder his brother-in-law for the purpose of securing his property. The Hottentots use the oil of tobacco to kill snakes, a single minute drop causing death as quickly as a lightning stroke. It is much used by gardeners and keepers of green-houses to destroy grubs and noxious insects. A number of instances are recorded in which instant death has been produced by applying a little of the oil from the stem or bowl of an old pipe to a sore upon the head or face of a small child. The poison of tobacco is so potent and violent in its action that even the external application of the moist leaves to the skin is suffi¬ cient to produce most serious symptoms. If a cigar be unrolled and the leaves composing it be applied over the stomach, great nausea will be produced in a very short time. This method has been used to in¬ duce vomiting. Cowardly soldiers have been known to place tobacco leaves under their arms just before a battle, for the purpose of pro¬ ducing sickness. Some years ago a man was detected in attempting to smuggle a quantity of tobacco by placing the leaves next to his skin. The nearly fatal symptoms which followed led to the discovery of the smuggler. If tobacco is poisonous when applied to the skin, it is doubly so when inhaled. The smoke of tobacco contains, in addition to nicotine, several other poisons, the chief of which are 'pyridine, picoline, sul- phureted hydrogen, carbon di-oxide, carbonous oxide, and prussic acid, all of which are fatal poisons when received into the system in any other than the most minute quantities. Thus, it is not to nico¬ tine alone that the evil effects of smoking are due, but to all of these poisons combined. Birds, frogs, and other small animals, die when exposed to the fumes of tobacco in a confined space. Inhalation is the most speedy way of getting any volatile poison into the system. The reason of this is obvious when the fact is made known that the lungs present a mucous surface fourteen hundred square feet in extent, every inch of which is in the highest degree ca¬ pable of absorbing gaseous substances brought in contact with it. This membrane is of the most marvelously delicate character, being of such exceeding thinness that it forms scarcely any obstacle to the pas¬ sage of gases which enter the lungs by respiration. Just underneath 510 STIMULANTS AND NARCOTICS. this delicate membrane passes all the blood in the body, or an amount equivalent to the whole volume of the blood, once every three minutes. The vapory poison inhaled by the tobacco-smoker is not simply taken into the mouth and then expelled, but it penetrates to the remotest air-cells, and spreads itself out over the whole of the immense extent of membrane stated. Thus it is plain that the blood of the smoker is literally bathed in the narcotic fumes drawn from his pipe or cigar. So readily does the system receive the poison of tobacco in this way, that it has been repeatedly observed as a fact that persons who are engaged in the manufacture of cigars often suffer much from the characteristic effects of nicotine poisoning. When tobacco is applied to the mucous membrane, as in chewing and snuff-taking, its poisonous elements are absorbed in essentially the same manner as when applied to the skin, but much more rapidly. In chewing, considerable quantities are also absorbed through the stomach, being swallowed with the saliva. Poisonous Effects of Tobacco. — Very few users of the weed need to have a description of the effects of a moderate degree of poisoning with tobacco. The giddiness, nausea, and deathly sickness which fol¬ low the first attempt to use the poisonous drug are indubitable evi¬ dence of the poisonous character of tobacco, which evidence is con¬ firmed by the difficulty — in many cases very great — experienced in becoming accustomed to its use. In severe cases of poisoning, violent vomiting and purging, vertigo, deathly pallor, dilatation of the pupil, a staggering gait, disturbed action of the heart, interference with res¬ piration, and in extreme cases insensibility and syncope, are commonly observed. Only a very small quantity is necessary to produce these sjnnptoms in a person not accustomed to the use of the drug ; but in persons who have accustomed their systems to the poison, a much larger amount is required. Dr. Richardson, who has recently given the effects of tobacco upon the human system a very thorough investigation, thus describes the condition of a person learning to smoke : — “ From analogy derived from the lower animals, which must be very perfect, the conditions of the vital organs are as follows : — “ The brain is pale and empty of blood, the stomach is reddened in round spots, so raised and pile-like, that they resemble patches of dark Utrecht velvet ; the blood is preternaturally fluid ; the lungs are pale as the lungs of a calf, when we see them suspended in the shambles ; EFFECTS OF TOBACCO ON THE BLOOD. 511 while the heart, overburdened with blood, and having little power left for its forcing action, is scarcely contracting, but is feebly trembling* as if, like a conscious thing, it knew its own responsibility and its own weakness. It is not a beating, it is a fluttering heart ; its mech¬ anism is perfect, but each fibre of it to its minutest part is impreg¬ nated with a substance which holds it in bondage and will not let it go. Why all Smokers do not Die of Tobacco-Poisoning. — It is often objected that while chemistry and scientific experiments seem to prove that tobacco is a powerful poison, the experience of thousands of persons disproves the theory of its poisonous character, since if it were so intense a poison as described, cases of death from tobacco- poisoning would be much more frequent. To this objection we answer, — 1. One reason why so few persons are reputed to die of nicotine or tobacco poisoning, is the wondei’ful faculty the system possesses of accommodating itself to circumstances. Through this means the worst poisons may by degrees be tolerated, until enormous doses can be taken without immediately fatal effects. Corrosive sublimate, strychnia, belladonna, and many other poisons, may be thus tolerated. 2. In our opinion, the majority of tobacco-users do die of tobacco¬ poisoning. Death as surely results, ultimately, from chronic as from acute poisoning, though the full effects are delayed, it may be, for years. A man who dies five or ten years sooner than he should, in consequence of tobacco-using, is killed by the poison just as truly as though he died instantly from an overdose. Effects of Tobacco on the Blood. — The blood is the life-giving stream which carries to each of the tissues and organs of the body the material out of which it is to be built and repaired. In it are found the various elements which are received into the system through the stomach, the lungs, and the skin, the three great inlets to the body. If poisons are taken into the system, it is through the blood that they do their devastating work. Anything which affects the blood must affect every organ and tissue of the body. When taken in any form, tobacco very readily finds its way into the blood, and, according to Dr. B. W. Richardson, it produces in the vital fluid very serious changes. He describes these changes in the following graphic words : — “ On the blood the prolonged inhalation of tobacco produces changes which are very marked in character. The fluid is thinner 512 STIMULANTS AND NARCOTICS. than is natural, and in extreme cases paler. In some instances the deficient color of the blood is communicated to the body altogether, rendering the external surface yellowish white and puffy. The blood, being thin, also exudes too freely, and a cut surface bleeds for a long time, and may continue to bleed inconveniently, even in opposi¬ tion to remedies. But the most important influence is exerted over those little bodies which float in myriads in the blood and are known as the red corpuscles. These bodies have naturally a double concave surface, and at their edges a perfectly smooth outline. The absorp¬ tion of fumes of tobacco necessarily leads to rapid changes in them ; they lose their round shape, becoming oval and irregular ; and instead of having a mutual attraction for each other and running together, a good sign of physical health, they lie loosely scattered before the eye, and indicate to the learned observer, as clearly as though they spoke to him and said the words, that the man from whom they were taken is physically depressed and deplorably deficient both in muscu¬ lar and mental power.” For a representation of the effects of tobacco on the blood, see Plate XIV. Tobacco not only deteriorates the blood, poisons it, and greatly im¬ pairs the blood corpuscles, but also disturbs the circulation through its influence upon the nervous system. Having seen the effects of this poison upon the blood, it may be readily understood that it cannot but be a cause of disease. Tobacco Predisposes to Disease. — By its deteriorating influence upon the system, tobacco lessens the vital resistance of the body to other causes of disease, and so produces a predisposition to nearly all classes of maladies. As bearing upon this point we may quote the fol¬ lowing from eminent authorities : — “ Look at the pale face, imperfect development, and deficient mus¬ cular power of the inhabitants of unhealthy, malarious districts. They live on, but with only half the proper attributes of life. So it is with the habitual smoker.” — Mr. Solly, F. E. S. “ I do not hesitate to say that if a community of both sexes, whose progenitors were finely formed and powerful, were to be trained to the early practice of smoking, and if marriage were confined to the smokers, an apparently new, and a physically inferior, race of men and women would be bred up.” “ The effects of this agent, often severe even in those who have at¬ tained to manhood, are especially injurious to the young who are still EFFECTS OF TOBACCO. 513 in the stage of adolescence. In these the habit of smoking causes im¬ pairment of growth, premature manhood, and physical prostration.” * A British officer in India stated that of eleven officers sent out on an expedition, only two escaped in good health, and they were non- smokers. In speaking against tobacco, Dr. Edward Smith, an eminent En¬ glish author and sanitarian, remarked, “ The whole tendency of its ac¬ tion is toward disease, and it is impossible to say how much of good it has prevented.” Smokers’ Sore Throat. — The redness and dryness of the mucous lining of the mouth and throat so common with smokers, is the result of the direct irritation of the hot fumes of the poisonous weed which are drawn in through the pipe or cigar. This cause of chronic disease of the throat is so very common that “ smokers’ sore throat ” has come to be recognized as a distinct malady. Some smokers pretend to smoke for the cure of throat difficulties ; but the excuse is a mere pre¬ tense in most cases. Tobacco never cures sore throat. It may tem¬ porarily relieve local irritation, but can do no more, and always in¬ creases the disease. Tobacco and Consumption,— The relation of impure air to dis¬ ease of the lungs is everywhere recognized. It has been very clearly demonstrated that breathing impure air is the great cause of consump¬ tion, on account of the effect of poisonous elements upon the blood and upon the lungs. Even the impurities gathered from the blood it¬ self exist in such cpiantities in air which has been once breathed as to render it unsafe to breathe again. This being the case, it will be read¬ ily seen that filling the lungs with nicotinized smoke and the hot fumes of tobacco from a pipe or cigar for several hours a day, cannot but be a most certain cause of lung disease. Moreover, experience shows this to be the case. Dr. C. R. Drysdale, the chief physician to the Metro¬ politan Free Hospital of London, declared, in an article in Public Health, that “ smoking in youth is no uncommon cause of pulmonary consumption.” Tobacco a Cause of Heart-Disease. — The effect of tobacco upon the heart is indicated by the pulse, which is a most accurate index to the condition of the heart. The pulse of a tobacco-user says, in terms as plain as any words could, that his heart is partly paralyzed, 33 * Diseases of Modern Life. 514 STIMULANTS AND NARCOTICS. that its force and vigor are diminished, that it is, in fact, poisoned. Old smokers, and not a few of those who have indulged but a few years, often suffer with palpitation of the heart, intermittent pulse, angina pectoris, and other symptoms of derangement of this most im¬ portant organ. There is, in fact, a diseased condition of the heart which is so characteristic of chronic tobacco-poisoning that it has been very appropriately termed “ narcotism of the heart.” Medical statis¬ tics show that about one in every four smokers has this condition. There is good evidence for believing that not only functional but or¬ ganic disease of the heart may be occasioned by the use of tobacco. Tobacco and Dyspepsia. — Notwithstanding the fact that tobacco is very frequently recommended as a sovereign remedy for dyspepsia, we have become convinced by careful observation in hundreds of cases, that it is never a cure, and is in hundreds of instances a cause of dvs- pepsia. Tobacco is a narcotic. The effect of narcotics generally is to lessen the secretion of gastric juice, and to decrease the activity of the stomach. Tobacco does this in a very marked degree. A man who is hungry may appease his desire for food by using tobacco if he is accustomed to it, or by the employment of some other narcotic. The desire is appeased, although the want still exists. It is through this same paralyzing influence that tobacco impairs digestion. Snuff-tak¬ ing occasions dyspepsia by producing irritation of the nasal mucous membrane, which affects the stomach through sympathy. A man cannot use tobacco to any considerable extent without be¬ coming a dyspeptic. It is the impairment of digestion which renders tobacco so efficient an agent, in most cases, in reducing flesh. We have treated scores of tobacco dyspeptics and have no hesitation in affirming that the disease is incurable without the discontinuance of the habit. Even when the habit is abandoned, a cure is often difficult, requiring months of careful attention to diet and treatment. Tobacco a Cause of Cancer. — There is no chance to doubt that tobacco-using is often a cause of this terrible disease. All eminent surgeons testify that they frequently meet cases of cancer of the lip and tongue which have been occasioned by smoking. A number of such cases have come under our observation, and we do not doubt that a large share of cancers of the lip and tongue originate in this way. This view is further strengthened by the fact that in the great cancer hospital of London, where more than ten thousand cases of this terrible disease have been treated, the number of men suffering from the disease EFFECTS OF TOBACCO. 515 upon the lip and tongue was three times as great as the number of women so affected, although the female cancer patients outnumbered the men five to one. Tobacco Paralysis. — In the last thirty years there has been a great increase in the frequency of the occurrence of a peculiar form of paralysis which seems to affect especially the nerves that supply the muscles, causing gradual wasting and loss of muscular power, which is fairly attributable to the increasing use of tobacco, as it most often occurs in tobacco-users. A form of progressive paralysis of the optic nerve, causing “ to¬ bacco amaurosis,” or blindness, is well recognized by oculists. These cases generally recover when the tobacco is discontinued, and will not get well so long as it is used. Tobacco-blindness is very common in Ireland, where very strong tobacco is used. It is caused both by smoking and chewing. Color-blindness, an affection which is increasing to an alarming ex¬ tent, especially in Belgium and Germany, where smoking is more ex¬ tensively practiced even than in this country, has been found to be largely attributable to the use of tobacco. This fact was first made known by an eminent Belgian physician who made extensive investi¬ gations upon the subject at the request of the Belgian government. Nervousness from Tobacco. — Tobacco-users suffer much from nervousness, which is manifested in a great variety of ways. One per¬ son is easily startled, another is unnaturally irritable, is cross and irasci¬ ble ; another cannot sleep at night ; still another suffers with trembling of the hands, which greatly discommodes him in writing. In scores of cases we have seen these symptoms all disappear when the use of to¬ bacco was discontinued. Temporarily, tobacco seems to give tone and strength and steadiness to the nerves, but the seeming strength is de¬ ceptive. It is purely artificial, and the ultimate effect is to increase the very difficulty which it seems to cure. We have often known wives and young children to suffer very se¬ verely from various nervous disorders which were wholly due to the effect upon their delicate organizations of the poisonous fumes of to¬ bacco which they received through the poison-laden exhalations of their smoking1 husbands and fathers. Dr. L. G. Alexander, of Kentucky, in a late article in the Philadel¬ phia Medical and Surgical Reporter, in which he gave an account of 51G STIMULANTS AND NARCOTICS. several cases of tobacco-blindness, remarks as follows respecting tobacco and nervous diseases : — “ The use of tobacco is so general that its bad effects can hardly be estimated. So much has been written, pro and con, that to discuss the subject is superfluous. The rapid increase of nervous people, nerve pain, neuralgia, and obscure nervous disease, is seen in practice every day by the physician, and is so frequent as to attract the attention of the laity ; and it is my belief that the common use of tobacco, as well as of alcohol and opium, is the most prominent cause of so many nervous troubles.” Plenty of evidence exists to show that tobacco-using is a very com¬ mon cause of impotence, together with the many other forms of nervous disease arising from its poisonous effects. Numerous other maladies might be mentioned as being caused, either directly or indirectly, but it will suffice to say that there is scarcely a functional disorder or an or¬ ganic disease to which the human system is subject, which may not be either produced or aggravated by this subtle poison. Hereditary Effects of Tobacco-Using. — There is no vice or habit to which men are addicted the results of which are more certainly trans¬ mitted to posterity than are those of tobacco-using. A vigorous man may use tobacco all his life and be able to convince himself all the time that he is receiving no injury ; but the children of that man, who ought to inherit from him a vigorous constitution and high health, are instead robbed of their rightful patrimony, and enter upon life with a weakly vital organism, with a system predisposed to disease and destined to pre¬ mature decay. The sons of an inveterate tobacco-user are never as ro¬ bust as their father ; and the grandchildren, in case the children are tobacco-users, are certain to be nervous, weakly, sickly creatures. This fact we have verified in so large a number of cases that we make the statement fully prepared to maintain it by indisputable facts. The physician last quoted, in the same article referred to, remarked on this question as follows : — “ From observation I have found that the children of parents addicted to the use of tobacco are more likely to have nervous diseases than others born of parents who do not use it ; and if both parents use it, we are almost certain to find the offspring of a nervous temperament, and espe- cially liable to nerve derangement. It is from this class that drunkards are mostly recruited. Growing up with a weak nerve development, any physical or mental exertion brings on the disease now so common, neu¬ rasthenia.” APOLOGIES FOR TOBACCO-USING CONSIDERED. 517 Moral Effects of Tobacco-Using. — There can be no question but that tobacco has a seriously deteriorating effect upon the character, blunt¬ ing moral sensibility, deadening conscience, and destroying that delicacy of thought and feeling which is characteristic of the true Christian gen¬ tleman. This effect is far more clearly seen, as would be expected, in youth who begin the use of tobacco while the character is receiving its mold, than in those who have adopted the habit later in life, though too often plainly visible in the latter class of cases. There can be no ques¬ tion but that the use of tobacco is a stepping-stone to vices of the worst character. It is a vice which seldom goes alone. It is far too often ac¬ companied with profanity and laxity of morals, and leads directly to the use of alcoholic drinks. It is indeed the most powerful ally of intemper¬ ance ; and it is a good omen for the temperance cause that its leaders are beginning to see the importance of recognizing this fact and promulgat¬ ing it as a fundamental principle in all temperance work. By this means only can any real headway be made against the great evils of intem¬ perance. Apologies for Tobacco-Using Considered. — We have already devoted as much space as is proper to the subject of tobacco-using, and can only notice briefly one or two of the more specious arguments used in favor of the drug. Probably the most powerful argument offered in behalf of the to¬ bacco habit is the assertion by certain physicians that tobacco, along with alcohol and kindred drugs, is a sort of “ negative food,” diminishing the necessity for food by lessening the wastes of the body. As already shown, in reference to alcohol, this argument is ingenious ; but instead of proving the desirability of the drug, it proves the opposite. The ar¬ gument is just as good for tobacco as for alcohol. The fact that the nat¬ ural secretions are diminished by the use of tobacco, cannot be any more of a recommendation to the drug than to nitric acid and mercury, which will do the same, or indolence and malaria, which will have the same effect. What people of the present day need, with their gross habits of eating and drinking and deficient physical exercise, is not less excretion, but more. Torpidity of the liver, inactivity of the skin, deficient activ¬ ity of the kidneys, and constipation of the bowels, are among the great¬ est impediments to real mental and moral growth and culture in the present age ■ and these conditions are certain results of the use of tobacco. Another argument often strongly urged is, that, admitting, the un- 518 STIMULANTS AND NARCOTICS. natural character of the habit of tobacco-using, it is nevertheless made necessary by the artificial conditions of civilized life, by the ex¬ cessive mental strain and nervous excitability resulting. It is claimed to be essential as a means of soothing the tired brain and securing sleep. A full and complete answer to this argument is the fact that tobacco is itself a cause of the very conditions which it is supposed to remedy, as elsewhere shown ; and while it seems to act with tem¬ porary benefit in some cases, it ultimately aggravates the very troubles which it is used to relieve. Much more might be said upon this subject ; but we must leave it here, hoping that the candid reader will find no difficulty in agree¬ ing with us in the conclusion that tobacco is an unmitigated evil, and one which should be thoroughly and faithfully exposed on every proper occasion, until the public are well informed of its dangers. We conclude with the indorsement of the sentiment expressed by Charles Lamb, in his “ Farewell to Tobacco,” in the lines, — “ Stinking’st of the stinking kind, Filth of the mouth and fog of the mind, Afric, that brags her foison, Breeds no such prodigious poison. Henbane, nightshade, both together, Hemlock, aconite - ,” etc. TEA, COFFEE, AND CHOCOLATE. 519 TEA AND COFFEE. Under this head we shall consider tea, coffee, and cocoa, or chocolate. Tea consists of the dried leaves of a plant which is native to China, but is also grown in India and various other parts of the world, to which it has been introduced. The active principle of tea is theine, a narcotic alka¬ loid, of which it contains three to six per cent. The other most abundant constituent is tannin, of which it contains about twenty-six per cent. The remainder is made up of gum, vegetable fibre, sug¬ ar, fat, starch, and an aromatic oil to which its Fig-, 176. Stem of Tea Plant, showing Flowers. Varying flavor IS chiefly due. See Fig. 176. Coffee is the roasted berry of a plant native to Arabia and Abys¬ sinia, known as Coffcea Arabica, which is closely allied to the plant from which Peruvian bark is obtained, the source of quinine. Its active principle is caffeine, which is identical with theine, of which it contains about one-third as much as tea. It also contains tannin, though in less quantity than tea, together with gum, sugar, caseine, fat, and the other ingredients also found in tea. Chocolate is obtained from the seeds of the cocoa-palm, native of Mexico, the pods of a ground-nut, a shrub native of Zanzibar, and other sources. The substances from which it is produced are ground 520 STIMULANTS AND NARCOTICS. to a powder, then mixed into a paste with sugar, and dried in cakes. Cocoa, or cocoa nibs, consists of the nuts coarsely broken. The active principle of cocoa, or chocolate, is theobromine, the proportion of which, according to the analyses of Dr Stenhouse, is five per cent. Fig. 177. Leaf and Fruit of Cocoa, a. Cocoa Bean. Theobromine is closely related, chemically, to theine, with which it is practically identical. The remaining constituents are chiefly fat, starch, sugar, coloring matter, and woody fibre. See Fig. 177. Matt, or Paraguay tea, and chaat, or Abyssinian tea, are the leaves of trees or plants which possess active principles essentially the same in nature and properties as theine. See Fig. 178. HISTORY OF TEA AND COFFEE. 521 History of the Use of Tea and Coffee. — Among civilized na¬ tions, the use of tea and coffee, as well as of the other beverages named, is confined to modern times. It is said that coffee has been in use in Arabia, its native home, a thousand years, and that tea has been used in China and Japan for about the same length of time. It was not until the middle of the sixteenth century, however, that coffee was first introduced into Europe by the establishment of a coffee-house in Constantinople, and another century passed before it was introduced into England. Its introduction into Constantinople was vigorously opposed by the priests, who asserted that its use was contrary to the teachings of Mahomet ; but the desire for stimulation soon triumphed over religious scruples, and the Turks are now known as among the most inveterate coffee-users in the world. Its use was also opposed at its first introduction into more civilized lands, though far less vigor¬ ously than was the use of tobacco. From their full introduction to STIMULANTS AND NARCOTICS. rj22 t/MM civilized nations, only about two centuries ago, these beverages have gradually come in more and more extensive use, especially during the last half-century. The annual consumption of tea and coffee, and their congeners, at the present day, is estimated by competent authori¬ ties to be as follows : Tea, 3,000,000,000 lbs.; coffee, 1,000,000,000 lbs.; cocoa and chocolate, 100,000,000 lbs. Mat^ is used by at least 40,000,000 people, being the common beverage of the natives of South America, where the tree from which it is obtained grows abundantly without cultivation. It is probable that fully one-half the human race, if not a larger proportion, make use of one or more of these beverages. In England, tea is the favorite drink, 100,000,000 pounds being annually imported into that country. It is also the favorite beverage in Russia and Holland. In Turkey, Sweden, France, and Germany, coffee is the favorite. In the latter country the amount of coffee used is fourteen pounds for each person. Effects of Theine upon Man anil Lower Animals. — Numerous experiments upon the direct effects of theine, — as also its allied sub¬ stances, caffeine and theobromine, — conducted by Dr. E. Smith, Dr. Richardson, and others, show that in small or ordinary doses it causes an increased action of the heart, an increased elimination of carbonic acid through the lungs, loss of heat, and increased activity of the kid¬ neys. In larger doses, it produces nausea, vertigo, and finally insensi¬ bility and death. Dr. Edward Smith, after drinking an infusion made from two ounces of coffee, which probably contained about seven grains of caffeine, fell to the floor unconscious. A prominent official in the British army, now doing service in Africa, recently lost his favorite horse in a manner which is both sin¬ gular and instructive. A cook left a few pounds of tea in the sack which had contained it, which was filled with corn by a Kafir groom who knew nothing of the presence of the tea. Upon serving out the corn to a troop of horses, of course the last one received the larger share of the tea, which was eaten greedily with the corn. The result is thus described : — “ The animal plunged and kicked, and ran backward, at intervals galloping madly around, finally falling into a donga, where it lay dash¬ ing its head on the rocks, and was dispatched by an assegai thrust through the heart. The post-mortem appearances indicated extreme cerebral congestion.” Coffee also lessens the action of the skin. EVIL EFFECTS OF TEA AND COFFEE. 523 Evil Effects of Using Tea and Coffee.— The evil effects of the use of these popular beverages has made too evident their injurious character to allow of room to doubt their deleterious influence, not¬ withstanding the apologies offered for their use by those who are accustomed to employ them. These evil effects we will attempt to point out as briefly as possible. 1. They W aste Vital Force. — By the experiments of Dr. Smith, M. Gazeau, and many others, it is shown that the consumption of the body is greater under the influence of tea or coffee than at other times, since the amount of carbonic acid eliminated is greater than natural, the amount of carbonic acid sent out from the lun^s being: the best known measure of the rate of waste of the body. The amount of extra waste thus occasioned is shown by Dr. Smith’s experiments to be from one- fourth to one-tenth that of the whole waste of the body, whence Dr. Smith very consistently remarks that it is especially adapted to “ those who usually eat too much.” This is a tacit confession that at the least the use of tea is an expensive and wasteful habit. The fact that the activity of the kidneys is increased, brings to light another means by which force is wasted, while, as is confessed, no return is made for the expenditure. 2. Tea and Coffee Injure Digestion. — When taken upon an empty stomach these beverages produce, as is well known, serious irri¬ tation of the digestive organs. When taken with the food, impairment of digestion is produced in several ways ; (a.) By taking into the stom¬ ach too large a quantity of liquid ; (6.) By relaxing the stomach by the use of liquids of too high a temperature, by which, also, the activity of the gastric juice is impaired ; (c.) By precipitating the pepsin with the tannin which they contain. Chocolate is further injurious to digestion on account of the large amount of fatty substance which it contains. That the use of tea and coffee is a common cause of dyspepsia is an ob¬ servation made by all experienced physicians. At the last meeting of the British Medical Association, an eminent physician from Australia testified that dyspepsia from the use of tea and coffee is very common in that country. We have seen, personally, many scores of cases of which the use of these fascinating beverages was one of the chief causes. .3. The Use of Tea and Coffee Affect Injuriously the Nervous System. — This statement would seem to be satisfactorily established by 524 STIMULANTS AND NARCOTICS. its well-known temporary effects. It is well known that whatever ex¬ cites vital action above the normal standard, without supplying an extra amount of force to support the extra expenditure, invariably produces, as a secondary result, depression of vital action below the normal standard, or what is known as a reaction. That this' is one of the secondary ef¬ fects of the use of strong tea, is well known. Tea may be used so weak that the reaction is not noticed, but no doubt it is still felt in some de¬ gree by the organic system, if not by the nerves of animal life. This continued alternation of excitement and reaction must certainly result in injury to the nervous system, increasing the liability to nervous diseases of a functional character, such as neuralgia (neurasthenia), hys¬ teria, etc. Moral Effects. — The long-continued use of tea has a distinct effect upon the character. This has been too often noticed and remarked to be questioned. An eminent neurologist, writing in a recent number of the Journal of Mental and Nervous Disease, calls attention to this fact in the following remarks: “Irritability of temper, like dyspepsia, belongs in the category of symptoms produced by long-continued tea-drinking. “There are ‘tea sots’ in every great charitable. institution, — particu¬ larly those for the maintenance of the aged. Their symptoms are, gen¬ erally, mental irritability, muscular tremors, and sleeplessness.” t The eminent Dr. Bock, of Leipsic, writes as follows respecting the in¬ fluence of tea and coffee on character : — “ The nervousness and peevishness of our times are chiefly attributable to tea and coffee ; the digestive organs of confirmed coffee-drinkers are in a state of chronic derangement, which reacts on the brain, producing fretful and lachrymose moods. Fine ladies addicted to strong coffee have a characteristic temper, which I might describe as a mania for acting the persecuted saint. Chocolate is neutral in its psychic effects, and is really the most harmless of our fashionable drinks. The snap¬ pish, petulant humor of the Chinese can certainly be ascribed to their immoderate fondness for tea.” Tea-Drinkers’ Disorder.— That there is a distinct class of symp¬ toms characteristic of the effects of alcohol, of tobacco, of absinthe, and of opium, has long been generally recognized ; it is only recently, how¬ ever, that the mcrbid effects of tea have been sufficiently well studied by eminent physicians to secure the recognition of the fact that tea and cof¬ fee, as well as the other poisons mentioned, produce such a distinct class EFFECTS OF TEA-TASTING. 525 of symptoms. It is now conceded, however, that the use of tea may, and often does, produce a morbid condition which has been appropriately termed, tea-drinkers’ disorder. Less than a year ago, Dr. J. W. Morton of New York City, a phy¬ sician of eminence, was led by observing the symptoms of a case which occurred in his practice, to believe that tea is far from being the harm¬ less agent by many supposed. He at once began an investigation of the subject, and directed his attention to a large class of persons to be found in most large cities, known as “ tea-tasters.” The facts which his in¬ vestigation elicited are so valuable in this connection that we shall quote quite liberally from his paper on the subject which appeared in the Journal of Mental and Nervous Disease, for October, 1879. We quote as follows: — “ The pernicious effects of tea-tasting upon many of its followers, are well recognized by all their number. It seems to be accepted among them, without discussion, that many break down and are obliged to give up the business, or else pursue it with much caution and at con¬ stant inconvenience to their health. And those of the public who are at all familiar with the facts, entertain the same view. Indeed, I may say that if I were now to express an opinion, based upon my present, it is true not yet sufficiently extensive, information upon the subject, I should feel inclined to say, that no one engages for several years in the profession of ‘ tea-tasting ’ without suffering both immediate and perma¬ nent harm to health.” “ This feeling is well illustrated in the remark of a prominent wealthy tea merchant, who said, ‘ I would rather give a hundred thousand dol¬ lars than have my son become a “ tea-taster.” ’ “ At first glance, to witness the operation of tasting, it would hardly seem possible that the very small amount of tea used at any one time could result in harm. This amount is only equal in weight to a five- cent piece, about fifteen grains. About two ounces of well -boiled water are turned on to this, and the infusion is allowed to ‘ draw,’ perhaps, fifteen minutes. Of this infusion the taster takes but a few spoonfuls into his mouth, and often spits it out again ; he also at intervals inhales the steam. But the harm comes, of course, from the constant repetition of these acts. “ The cases which I propose to relate exhibit the extreme physiolog¬ ical action of an infusion of tea. They are cases of acknowledged ex¬ cess; and in this lies their interest, for by familiarity with the symptoms 526 STIMULANTS AND NARCOTICS. of excess, we shall be able to thread our way back to those of modera¬ tion, and to point out, it may be, that what many perhaps consider moderation is, in reality, abuse, and that certain symptoms put down as ‘ nervousness,’ ‘ nervous irritability,’ and ‘ nervous exhaustion,’ as well as the more clearly defined ailments of dyspepsia, hypochondria and hyperemia, may sometimes be attributed to the misuse of a common domestic beverage. Indeed, I am forced to think that many people, un¬ consciously to themselves and to their physicians, suffer from a train of symptoms due to tea (or its congener, coffee). We often find people taking tea to relieve the very set of symptoms which its abuse, as will be shown later, produces ; and it is often the fact that patients date their recovery from a dyspepsia or nerve exhaustion from the time when they gave up their tea.” The following is an account of one of the cases observed : — “ The immediate effects upon him are as follows : In about ten minutes the face becomes flushed, the whole body feels warm or heated, and a sort of intellectual intoxication comes on, much the same in character, it would seem, as that which occurs in the rarefied air of a mountain. He feels elated, exhilarated, troubles and cares vanish, everything seems bright and cheerful, his body feels light and elastic, his mind clear, his ideas abundant, vivid, and flowing fluently into words. He has found from experience that the workings of his intel¬ lect are really more clear and vigorous than at any other time. This is not a delusion on his part, for at this time he can “ talk a man over,” and make a more advantageous bargain than at others. © © “ At the end of about an hour’s tasting a slight reaction begins to set in ; some headache comes on ; the face feels wrinkled and shriv¬ eled, particularly about the eyes, which also get dark under the lids. “ At the end of two hours this reaction has become fully estab¬ lished, the flushed, warm feeling has passed off, the hands and feet are cold, a nervous tremor comes on, accompanied with great mental de¬ pression. And he is now so excitable that every noise startles him ; he is in a state of complete unrest and mental exhaustion ; he has no courage to do anything ; he can neither walk nor sit down, owing to his mental condition, and he settles into a complete gloom. His body in the meanwhile does not feel weary. Copious and frequent urina¬ tion is always present, as also certain dyspeptic symptoms, such as eructations of wind, sour taste, and others. “ The above-described immediate effects follow a single afternoon’s © EFFECTS OF TEA-TASTING. 527 tea-tasting. They may be summed up briefly as, excited circulation, intellectual intoxication, with actual increased vigor of mind power, increased urination ; then a period of collapse indicated by cold ex¬ tremities, tremulousness, mental irritability and anxiety. It will be several days before this condition of affairs is amended. And at this time the temptation to take alcoholic stimulants is very strong. “ The chronic effects are few and decided. Headache is frequent, principally frontal and vertical ; a ringing and buzzing in the ears is ver}7 constant ; black spots often flit before the eyes, and he sees flashes of light. Vertigo also is very persistently present ; he cannot look up at a clock on a steeple without staggering. Insomnia exists to a considerable extent ; he seldom has a good night’s sleep, and he dreams much, but his dreams are of a pleasant character ; he some¬ times sees visions when not sleeping. Dyspepsia is more troublesome than any of the foregoing three symptoms. This the patient assigns strictly to tea-tasting, since it is made worse by tea, and improves when he abstains from it, though now becoming confirmed. His ap¬ petite is captious, he feels heavy at the epigastrium, he has eructations and a sour taste, and finds that certain kinds of food distress him. He has a frequent gurgling, and is in the habit of ‘ working ’ his whole chest and abdomen to make the gas pass on. “ His mental condition is peculiar. He lives in a state of dread that some accident may happen to him ; in the omnibus, fears a collis¬ ion ; crossing the street, fears that he will be crushed by passing teams ; walking on the sidewalks, fears that a sign may fall, or watches the eaves of the houses, thinking that a brick may fall down and kill him ; under the apprehension that every dog he meets is going to bite the calves of his legs, he carries an umbrella in all weathers as a defense against such an attack. He often dreads entering his office for fear of being told that some business friend has failed ; and in short, lives in a state of constant foreboding of some impending evil. At times his left leg drags and feels numb, and he is conscious of an unsteady gait. He has also often a twitching of the muscles of the face and eyelids. “ The chronic effects as above described, as distinguished from the immediate effects, are, in brief, vertigo, headache, insomnia, dyspepsia, mental depression, almost amounting to delusions, and also some slight subjective and objective signs of a central disturbance of both sensibil¬ ity and motility. “ I omit negative evidence indicating that otherwise than as re¬ lated, he is in sound health. 528 STIMULANTS AND NARCOTICS. “A certain group of his symptoms point to hyperemia of the brain, another to disorder of the digestive function, and still another to morbid alterations of intellection, sensibility, and motility; all taken together presenting, as I venture to suggest, a clinical picture of tea-poisoning.” Similar effects were observed in all the cases investigated. In or¬ der to still more conclusively establish the relation between the effects described and the use of tea, Dr. Morton conducted a series of exper¬ iments in the use of tea himself, and obtained similar effects to those described by the persons interviewed. Since the' publication and circulation of his observations, an attempt has been made to dis¬ credit his statements, which was undoubtedly prompted by those en¬ gaged in the business and who are fearful of suffering pecuniarily through the diminution of the use of tea. The observations of Dr. Morton are, however, so well confirmed by other observers that the at¬ tempt has proved a futile one. To the eminent medical testimony against tea already given, we may add the following from Dr. B. W. Richardson: — “ Some functional nervous derangements are excited by fluids com¬ monly consumed with, or as, foods. Tea taken in excess is one of these disturbing agents. Tea exerts an astringent action, and by the presence in it of an organic substance, theine, it exercises a special in¬ fluence over the nervous system, which, to say the least, is tempora¬ rily injurious. I believe the effects from tea are more severely felt by the young, and that as middle age approaches, they are less severe. “ The symptoms which indicate the injurious action of this article of food are sufficiently characteristic. They are, intensely severe head¬ aches, constipation of the bowels with what is usually considered to be deficiency of bilious secretion, flatulency, an unsteadiness and feeble¬ ness of muscular power, and, not infrequently, a lowness of spirits amounting to hypochondriacal despondency. In children under the influence of tea this lowmess of spirits is often very severe, so severe that the occurrence of the simplest natural phenomena, as the ap¬ proach of darkness, the cast of a large shadow, or the spreading over the sky of dark clouds, are sufficient to create dismay and fear. “ In poverty-stricken districts, amongst the women who take tea at every meal, this extremely nervous, semi-hysterical condition from the action of tea is all but universal. In London and other fashion¬ able centers in which the custom of tea-drinking in the afternoon has AEG U ME NTS CONSIDERED. 529 lately been revived under the old name of * the clruni,’ these same nerv¬ ous symptoms have been developed in the richer classes of society, who, unfortunately, too often seek to counteract the mischief by re¬ sorting to alcoholic stimulants. Thus one evil breeds another that is worse. “ The flatulency induced by tea taken late in the evening has the effect of interfering with the processes of sleep ; it prevents or disturbs sleep by dreams and muscular startings, and is a common cause of that peculiarly painful symptom known as nightmare. “ The extremely injurious effects of tea are best seen in some of those who are charged with the commercial duty of what is called ‘ tea-tasting.’ A professed ‘ tea-taster ’ who was so seriously affected by the process that he thought it proper to consult me on the symp¬ toms induced, defined the symptoms very clearly as follows : ‘ Defi¬ ciency of saliva ; destruction of ta,ste for food ; biliousness ; nausea ; constipation ; an extreme and unclefinable nervousness ; and night¬ mare whenever sleep is obtained.’ “ The symptoms from which habitual tea-drinkers suffer are iden¬ tical in character, but minor in degree.” “ Coffee, like tea, induces dyspepsia, and perhaps, with even more -activity than tea, it keeps the brain awake when that wearied organ ought, according to nature, to be asleep.” ARGUMENTS IN FAVOR OF TEA AND COFFEE CONSIDERED. Notwithstanding the numerous facts against these beverages, so popular is their use that there are many who profess to find apologies for employing them ; a few of these we will now consider. 1. Tea and Coffee Sustain the Strength. — The same argument urged for tobacco and alcohol is also presented in favor of tea and coffee ; but its value is no greater in the case of the latter than in that of the former. That it does not sustain either muscular or nervous strength is shown by scientific experiments which cannot be refuted by any num¬ ber of unreliable accounts of the great amount of work which can be performed by persons who take little else than tea. Dr. Smith remarks that the use of tea appears to increase muscular activity, as under its in¬ fluence there is greater ease in making exertion ; but he immediately adds that if exercise be taken, “a greater sense of exhaustion follows’ than when tea has not been taken ; which shows, most conclusively, 34 530 STIMULANTS AND NARCOTICS. that the feeling of strength is not real, but deceptive, and that a person is really less fitted for exertion of any kind while under the influence of tea than at other times. Dr. Smith further remarks, in summing up the effects of tea, that exercise while under its influence is followed by “reaction, with a sense of exhaustion,” and this is said to be felt even after having had a night’s rest. No better evidence of the damaging influence of these drugs could be required. If it be argued that the amount taken by ordinary consumers of tea is insufficient to produce any ill effect, we have but to call attention to the fact that the wealthy, besides using the strongest tea, take it in doses even larger than those employed by Dr. Smith in his experiments. It is not at all uncommon for persons with whom expense is not an item of moment, to take at each meal a quantity of the infusion of tea of such strength as to contain not less than five to fourteen grains of theine, a smaller amount than which has been known to cause unconsciousness and temporary paralysis. A single teaspoonful of dry tea may contain seven or eight grains of theine, and this is not an uncommon allowance for each person at a meal. 2. Tea and Coffee Soothe the Nerves.— How do they soothe the nerves ? Do they furnish the requisite material for repairing the worn and exhausted organs ? No. They only temporarily excite them, so that their real condition is for a time obscured ; but when their evan¬ escent effect has vanished, the nerves are in greater need than before of being soothed, and each application of the remedy makes the evil worse. This is the reason why we seldom find a confirmed tea-drinker who is not troubled with nervousness. It is also equally true that the great majority of sufferers from this disease are tea or coffee drinkers. In hundreds of instances these nervous tea-drinkers have fully and speedily recovered their health by abandoning their use of the article. This is a sure and simple remedy. 3. Tea and Coffee Assist Digestion. — “ Mv stomach is so weak,” says a tea-drinking dyspeptic, “ that a cup of good strong tea is neces¬ sary to enable me to digest my meal.” Yes ; this is doubtless the case ; and if you continue the practice you will find, after a time, that two or three cups will be necessary to enable you to dispose of your dinner sat¬ isfactorily. Then if you persevere in the habit, in spite of the admoni¬ tions of your best medical adviser, nature, you will shortly find it quite impossible to swallow a sufficient quantity of the beverage to make your stomach perform its work. Then you will begin to realize the fact that AEG UMENTS CONSIDERED. 531 goading an organ into action is quite a different thing from encouraging and promoting its healthy activity by supplying it with healthful, nour¬ ishing food. Do not be deceived by momentary sensations. Consider the ulti¬ mate effects, and you cannot fail to be convinced that instead of pro¬ moting digestion, tea and coffee are most effective disturbers of that function. How they interfere with digestion has already been explained. 4. Tea and Coffee Relieve Headache. — How invariably the un¬ suspecting lady resorts to a cup of tea to relieve the distress occasioned by that common malady, sick-headache ! Yes ; and how invariably that same sick-headache returns ! Who ever heard of a person who was per¬ manently cured of sick-headache by tea-drinking ? Such a thing would be impossible. Tea and coffee are among the prime causes of sick-head¬ ache, although they afford temporary relief, just as tobacco and alcohol are prolific causes of tremors, but yet appear to steady the trembling nerves for a short time. 5. Tea -and Coffee Supply the Place of Food. — Many people who are largely addicted to the use of the articles will prefer a cup of strong tea or coffee to a hearty meal of nourishing food. Indeed, it is a general custom with the English peasant to reduce his bread fare one- half that he may be able to procure a cup of tea to accompany the re¬ mainder. Dr. Arlidge, of England, has recently called attention to the fact that the women of the working-classes in that country have carried this practice of substituting tea for food to such an extent that they are beginning to manifest the most unmistakable evidence of narcotic poisoning. Tea silences the demand of the system for food, but it does not in any respect replace it, as may be seen by the weakened energies and the at¬ tenuated forms of those who use it largely. As elsewhere remarked, Dr. Smith has shown that tea-drinkers need more food than others instead of less. 6. Tea and Coffee Increase Mental Yigor. — Those who make this claim, mistake mental activity for mental strength. A greater error could not be made ; and yet this fallacious notion is very popular. See the poor victim of delirium tremens trembling with fright at the fan¬ tastic and threatening shapes which his excited fancy portrays. His imagination was never so active in health. Now it makes him see © forked tongues darting at him from every corner, and converts every 532 STIMULANTS AND NARCOTICS. shadow into a monster. Who will venture the assertion that his mind is stronger now than when in health ? Listen to the ravings of the patient during the delirium of fever ; the mind is certainly active, hut it cannot be said to be strong ; for strength is only consonant with health. When the brain is stimulated to unnatural activity by tea, coffee, tobacco, alcohol, or any other stimulant, it makes violent attempts to accomplish whatever task may be imposed upon it. But the calm, de¬ liberate action of the mind is impossible. The highest efforts of genius can never be exhibited under such circumstances. Is it argued that some of our greatest mental workers, as Voltaire and Johnson, were users of tea or coffee, we would, in answer, call attention to the nervousness, irritability, and irascibility which notably characterized the last years of the life of each of these men. Here we see the legitimate results of the use of tea and coffee, and it is very probable that had these men been more nearly correct in their habits of life they would have achieved even greater success than they did. It was long ago decided by eminent physicians that excitement is not strength. It has quite as long been recognized that every unnatural increase of physical or mental action must be followed by a correspond¬ ing descent below the average standard of activity. Then every minister who drinks a cup of strong tea to increase the animation of his discourse, borrows a certain amount of vivacity and en¬ ergy from some future effort. So every student who goads up his weary brain with a cup of tea to enable him to steal time from sleep, is making a double draft upon his capital of mental force and ability. So, too, the young lady who stimulates with tea to enable her to entertain her visitors, is laying the foundation for future intellectual poverty and mental inefficiency. 7. Tea and Coffee Correct the Injurious Effects of Poor Wa¬ ter.— When no other reason can be offered for the continuance of a bad habit, this one is frequently presented. Its absurdity makes it almost insusceptible of candid consideration. How strange that the addition of a poison to water already bad enough should improve it ! The asser¬ tion is wholly without foundation in fact, and never would have been advanced as an argument by tea-drinkers, except for the lack of any better. Two poisons are always worse than one unless they neutralize each other ; but no such chemical properties are claimed for tea and coffee. ARGUMENTS CONSIDERED. 533 8. Tea and Coffee are Necessary Condiments. — One writer upon dietetics tells us that the utility of tea and coffee does not depend upon their peculiar principle, theine, but that it is wholly the product of a certain aromatic oil which they contain, and which he denominates “ osmazome.” This gentleman argues that food cannot be digested un¬ less it is relished ; and that since tea and coffee, in company with other condiments, make the food more palatable to the taste, they must be essential to nutrition. While it is certainly true that the value of any article as a food de¬ pends very largely on its gustatory properties, it cannot be for a mo¬ ment supposed that the mere question of taste is sufficient to settle the nutrient quality of an aliment. In other words, an article may be ex¬ ceedingly pleasing to the taste, and yet be equally injurious to the health and quite unfit for food. If this were not the case, how would the epi¬ cure and the glutton rejoice ; for then they might gratify their appetites without restraint. Again, an article may possess little or no gustatory property,' and yet be a most valuable and indispensable aliment. Such is the case with pure water. We do not hesitate, then, to declare this argument for the use of tea and coffee to be without weight. It is, indeed, a fact now coming to be recognized more and more fully, that all condiments are not only useless, but injurious, tea and coffee with the rest. 9. Tea and Coffee are Substitutes for Food. — Tea and coffee, as well as alcohol and tobacco, have been called by some physiologists “ accessory foods,” because, as was alleged, they prevent the rapid disor¬ ganization of tissues, which always accompanies organic activity. It might be easily shown that this would be most undesirable, if it were really true ; for vital action is not only accompanied by organic change, but is inseparably connected with it. Some even say that it is depend¬ ent upon it. But we need not enlarge upon this, for it is claimed by our best authorities that careful experiments demonstrate the fact that change is accelerated instead of impeded by the use of tea and coffee. While we have little confidence in the reliability of any of these experi¬ ments, there being many chances for error, they are very interesting on some accounts. A popular writer says, “ Science almost always finds some founda¬ tion in fact for popular prejudices.” In this case we have a very excel¬ lent illustration of this fact. Quite a number of illustrious* individuals have been for some time recommending the use of tea and coffee, be- 534 STIMULANTS AND NARCOTICS. cause, as they claimed, they prevented the ordinary rapidity of tissue change, and so lengthened life and economized food. But now we find Dr. Smith, the author of the latest and most popular and reliable work on foods, telling the people that they should use tea and coffee because they increase the rapidity of tissue change, and so increase the available force of the individual. Thus it appears that those who use tea and coffee need to eat more food instead of less, as heretofore claimed. The only conclusion to be drawn from these facts is that even scien¬ tific men are sometimes so blinded by the fogs of appetite that they lose sight of true principles and allow themselves to be guided by their prej¬ udices. Reason and common sense must decide from the facts in the case, independent of all such contradictory, and hence unreliable, testi¬ mony. 10. Tea “Cheers and not Inebriates.” — Philosophers have spec¬ ulated, theologians have moralized, and poets have waxed eloquent, about “the cup that cheers and not inebriates.” Doubtless we shall startle such when we say that, although this is very pretty poetry, it is false in fact. Tea and coffee, as well as tobacco, are as truly capable of producing a condition of intoxication as is alcohol. Intoxication is a condition in which the sensibilities are paralyzed and the mind delirious. In more than one instance has this identical condition been induced by the use of tea and coffee. In Australia, drunkenness from the use of tea is very common. In South America, a person who is greatly addicted to the use of coca is called a coquero, which means the same as our word drunkard. The Mate or Paraguay tea of South America, the active principle of which is precisely the same as that of tea and coffee, produces not only intoxi¬ cation but delirium tremens. Abyssinian tea, another form of the same principle, used in Shoa and among the poorer classes in some parts of China, is said by Johnson to be very intoxicating. We have already referred to the fact that Dr. Edward Smith, of England, when conducting some experiments on the “ physiological ac¬ tion ” of coffee, fell to the floor insensible, in company with his assist¬ ant, as the effect of drinking strong coffee. Dr. Cole, of England, describes the cases of several individuals who were frequently found lying insensible as the result of tea-drinking. One case which he mentions was an author who was thus found two or three times a week. Indeed, the man who is so far bereft of his reason that he is wholly ARGUMENTS CONSIDERED. 535 insensible is not the only person who is drunk. Every man who takes into his system any kind of stimulant, be it tea, coffee, tobacco, opium, arsenic, or alcohol, is drunk just in proportion to the dose, and all his actions will be more or less unnatural. The word intoxicate is derived from the Latin word toxicum, poison, intoxicatum meaning to drug or poison. Intoxication, then, is a con¬ dition of poisoning ; and it is wholly immaterial whether opium, alcohol, tobacco, tea, or coffee, is the agent employed. Holding that tea and coffee are harmless beverages, many temper¬ ance workers have urged their introduction as substitutes for alcoholic drinks ; and for this purpose temperance ( ?) coffee-houses have been established in many of our large cities. We believe, however, that in the attempt to reform drunkards and prevent intemperance no greater mistake can be made than to attempt to substitute one stimulant or narcotic for another. It is possible that temporary benefit may be derived from the establishment of coffee¬ houses in districts where a sudden and extensive temperance reform - has been effected, but the ultimate effects of substituting tea or coffee for alcoholic drinks, as a cure for intemperance, will prove it to be a fatal error. The great sin of intemperance is not in the use of alco¬ hol, per se, but in the gratification of the desire for artificial stimu¬ lation. We fully believe that the use of tea and coffee, especially when it is begun early in life or indulged to any degree of excess, is a by no means insignificant cause of intemperance, the use of one stimulant leading to another, until the grossest forms of intemperance are reached. The facts to which attention has already been called in our consideration of the subject will justify this conclusion. We fully agree with the sentiment expressed by an eminent New York physician, that “ The only consistent teetotalism is that which abstains from all forms of stimulants and narcotics.” We thoroughly believe that more harm is done at the present time by tobacco, tea, and coffee, than by all forms of alcoholic drinks combined ; and we deem it of the greatest importance that the efforts of temperance workers should be turned in this direction. We are glad to see some omens of progress toward true teetotalism, one of the most promising of which is the recent formation of the American Health and Temperance Association, which, although only inaugurated on New Year’s of 1870, has already effected more than twenty auxiliary State societies, and more than a hundred local organizations, and secured a membership of more than 53G STIMULANTS AND NARCOTICS. ten thousand. The teetotal pledge of this Association requires absti¬ nence from alcohol, tobacco, tea, coffee, opium, and all other narcotics and stimulants .* The work of this organization is being pushed with vigor through its agents in all parts of this country, and in England, Sweden, Nor¬ way, and Switzerland. It is to be hoped- that other temperance organ¬ izations will take hold of this work also. THE USE OF OPIUM. Within the last few years the consumption of this narcotic drug has been increasing in this country to an alarming extent. Thirty years ago the amount of opium imported was about 130,000 pounds annually. To-day, according to the report of the chief of the Bu¬ reau of Statistics, it is not less than 400,000 pounds. Of this amount not more than one-fifth is used for medicinal purposes, leaving the enormous amount of 320,000 pounds to be disposed of by habitual users of the drug. The exact number of opium consumers cannot be determined with any degree of accuracy, as the devotees of the drug usually avoid disclosing the habit as much and as long as possible. Careful inquiries of druggists, and others likely to be the best posted, have elicited facts upon which it is perfectly safe to base the estimate that there are not less than 100,000, and very probably as many as 200,000, habitual opium-takers in the United States. Enormous Doses Taken. — The amount of opium consumed by an old opium-eater is sometimes enormous. We have had cases in which twenty grains of morphia, equivalent to 320 grains of opium, were taken at a single dose, with no more effect than would follow the administration of one-fourth of a grain to a person unaccustomed to its use. One of the most recent cases which have come under our care at the Medical and Surgical Sanitarium at Battle Creek, Michigan, was that of a woman who had been addicted to the drug for nine or ten years, and had increased the quantity from less than a grain a day to ninety-six grains in the twenty-four hours, equivalent to more than three ounces of opium, together with a pint and a half of brandy. Narcotic Nostrums. — In addition to this enormous consumption of opium by those addicted to its use, immense quantities are used in vari¬ ous quack nostrums and in so-called “ antidotes.” Probably the most * Those who desire further information respecting this organization can obtain it by addressing the Association at Battle Creek, Mich. CA USES OF THE OPIUM HABIT. 537 widely used nostrum containing opium is Mrs. Winslow’s Soothing Syrup, of which no less than 750,000 bottles, containing about one grain of morphia each, have been sold in a single year. This quantity is sufficient to destroy the lives of many thousands of infants, who are very susceptible to the influence of the drug, as no doubt it has done. Causes of the Habit. — Probably the greatest of all causes of this • enormous increase in the habit within the last few years is its reckless and uncalled-for use in medicine. It is the custom of many physicians to prescribe opium in some form for almost every ache or pain which they encounter in practice. If they find a patient suffering pain, whether from an acute attack of colic, a chronic neuralgia, a face-ache from a decayed tooth, a back-ache from some uterine disease, or a fractured limb, an opiate is at once prescribed, and often before ascertaining what may be the patient’s condition. We have treated quite a number of persons suffering from the opium habit, and have never met a case in which we were not informed by the patient that the habit began with a physician’s prescription. This is the general testimony of all who have examined this question. We have had patients who had been taught by their physician to take morphia by means of the hypodermic method (injection beneath the skin), whose bodies were so completely covered with scars that it was scarcely possible to find a spot within reach of the patient’s own hands, and not uncovered by the clothing, which had not been punctured by the needle of the hypodermic syringe one or more times. In one case, a patient was actually driven to seek relief from the terrible habit by sheer inability to find new places for puncturing the skin. The most common method of taking the drug, however, is by the mouth. The physician gives a prescription which the patient has filled and refilled, until the habit is firmly fixed. We have many times heard patients condemn in no stinted terms the physicians who first introduced them to the fascinating drug, apparently forgetting that they may have been themselves in a large measure to blame, since it is a most common thing for patients to demand of physicians medicines which will produce immediate palliative effects, not once thinking that nature must effect the cure, and that time will be required to remove the cause of the disturbance so as to obtain relief in a natural way. Effects of the Opium Habit. — The continued use of opium is followed by effects far more serious than those from the use of tea, coffee, tobacco, or alcohol. It is an evil that every physician ought to do his utmost to expose, warn against, and prevent. Probably 538 STIMULANTS AND NARCOTICS. physicians can do more than any or all other persons combined to cure the habit, by exercising care to avoid in every possible way and under all possible circumstances the use of opium as a medicine. There are numerous other measures of relieving pain, and all available means should be tried before resorting to this drug, so likely to make the sufferer whom it temporarily relieves a greater sufferer in the end. The government of Pekin has taken measures to check the enor¬ mous consumption of opium in that country by interdicting its use after the beginning of the present year, under a most severe penalty. If there is need of prohibitory legislation respecting any form of in¬ temperance, this certainly is the one of all others requiring it, and the one for which there seems to be the best chance for success. Tyranny of the Habit. — Of the fascinating powers of this drug and the extreme difficulty of overcoming the habit, so much has been written that we need say nothing. The confessions of the opium- eater, De Quincey, portray in far more graphic lines than could we, the terrible bondage of an opium slave. We should say a word, how¬ ever, with reference to its cure. The numerous antidotes for the opium habit advertised in the newspapers are the basest frauds imaginable. The examination of a large number of them by Dr. Prescott, of the Medical Department of the University of Michigan, a few years ago, showed them to be, without exception, compounds of opium. In this case the remedy is not worse than the disease, but identical with it. The habit is not incurable, however, as many suppose. With proper treatment all can be cured, and in a comparatively brief space of time. In the case mentioned, in which ninety-six grains of opium were taken daily, the patient, although suffering with an acutely painful disease, was completely cured in less than six weeks, though she had been ad¬ dicted to the use of the drug for many years, and in addition was ad¬ dicted to the use of liberal quantities of alcohol, a combination much more difficult of cure than either habit alone. Other patients have been cured in three or four weeks, or in shorter periods. The method of treatment is described elsewhere. Absinthe, Chloral, Ether, etc.— The use of absinthe, chloral, sul¬ phuric ether, and of other narcotics and stimulants, is followed by re¬ sults the most serious in character; but we have not the space to dwell upon these, as the evils consequent upon their use are of small impor¬ tance when compared with the great evils resulting from the use of the drugs to which we have already called attention. HYGIENE OF THE AIR. In this section we shall consider the composition of the air, the im¬ purities with which it is likely to he contaminated, the sources of contam¬ ination, disinfection, and the best modes of ventilation and heating. The Atmosphere. — The air is a very complex mixture of gases and minutely divided solids in the form of dust and minute germs. The chief and essential constituents of the air are nitrogen and oxygen, in the proportion of 79 parts of the former to 21 of the latter, ignoring the numerous other constituents, which are too small in quantity to be re¬ garded in this connection, though of immense importance in their rela¬ tions to health. Oxygen in the form of ozone is usually found in pure air in small proportions. In this state, oxygen is exceedingly active, and is a powerful disinfectant. Oxygen is converted into ozone by the action of the volatile oils of flowers and the vapor of resinous substances. It is abundant in pine forests on account of the slow evaporation of pitch. Its chief source, however, seems to be electricity, hence it is very abun¬ dant after a thunder storm. It is in part due to this fact that the air seems so much purer and fresher after such a storm. Carbonic acid is naturally found present in the air in the proportion of 4 parts in 10,000, or .04 per cent. Another essential ingredient is watery vapor, which is found in varying proportion according to the location, season of the year, temperature, and other varying conditions. It has been found by numerous experiments that the proportions in which oxygen and nitrogen are found in the air cannot be greatly changed without injury to health, although the nitrogen seems to be useful chiefly to dilute the oxygen, and may be replaced, temporarily at least, by such a neutral gas as hydrogen. If the oxygen is diminished, even so little as two or three parts in a hundred, respiration becomes very difficult, and a lighted candle burns very dimly. A slightly lower per¬ centage of oxygen is insufficient to support combustion. As air expands with the elevation of temperature, the equivalent amount of oxygen decreases. Thus, air at 90° F. contains an amount of oxygen equivalent to only about nineteen-twentieths of the usual 539 540 HYGIENE OF THE AIR. amount at 60° F.; while air at 32° F., on account of condensation of volume, contains an amount of oxygen equivalent to one-twentieth more than the usual amount at 60° F. It is this which causes the lassitude consequent upon a great rise in temperature, as also the habitual and characteristic inertness of the natives of hot climates. The fact also accounts for the tonic and invigorating effects of cold air. These obser¬ vations agree entirely with the results of experiments which show that the inhalation of an increased proportion of oxygen increases vital ac¬ tion, while the opposite effect is produced by a diminished quantity. An increase of altitude has an effect upon the atmosphere similar to that of increased temperature. The air rapidly diminishes in density, or grows thinner, as the altitude increases, so that at a height of a little less than three and one-half miles its density is only one-half of that at the surface of the earth. At an elevation of less than 9,000 feet the density of the air is decreased to such an extent that a given volume contains oxygen equivalent to only about three-fourths of that contained in an equal volume at the surface. An effect exactly the same in kind but less in degree is produced by the changes in barometric pressure which are constantly taking place. When the barometer falls, the air is thin¬ ner, and less oxygen is respired. When it rises, the opposite effect is produced. These facts account for the feeling of oppression and want of air experienced by those who ascend to great heights on mountains or by means of balloons. This we experienced in a very unpleasant de¬ gree in the Rocky Mountains at an altitude of less than 14,000 feet, upon attempting to exercise even in a very gentle manner. Persons who have ascended to greater heights have found the difficulty to increase propor¬ tionately with the altitude. The same facts also account for the enerva¬ tion and oppression often felt just prior to and during a storm, when the barometer usually falls, owing to the decrease in the density of the atmosphere. It will be readily understood that a sudden rise in temper¬ ature accompanied by a fall of the barometer would produce a double degree of interference with respiration, by decreasing the amount of oxygen inhaled at each breath. The amount of oxygen taken in at a single respiration with the thermometer at 80° and the barometer an inch and a half lower than usual, would be equivalent to only nine-tenths of the amount of oxygen taken in with the barometer at its usual height and the temperature at G0°. This very readily accounts for the extreme degree of enervation, and often prostration, felt, especially by nervous people and invalids, just prior to a storm in very hot weather. IMPURITIES OF THE AIR. 541 Persons living in an elevated atmosphere in some degree compen¬ sate for the diminished amount of oxygen in the air by increasing the amount taken in at each respiration. This is said to result in increas¬ ing the lung capacity of people residing in such localities. It is also supposed that the necessity for increased action of the lungs and the breathing of a larger amount of air is the means by which persons suffering with some forms of pulmonary disease are apparently ben¬ efited by residence in elevated districts. As before remarked, the amount of watery vapor in the air varies greatly with the locality, season, and other conditions. The air of countries located near the sea, or other large bodies of water, contains a large proportion of watery vapor when the wind is in the direction of the water. When the wind is blowing in the opposite direction, the air is apt to be quite dry. Just before a storm the air is usually nearly saturated with vapor. In the warm season of the year the de¬ gree of saturation of out-door air and that within doors is about the o same. In the winter season, however, owing to the higher tempera¬ ture of in-door air, it is very much drier unless watery vapor is added by artificial means. This is owing to the fact that air acquires by increase of temperature a greater capacity for absorbing moisture. This point need not be dwelt upon further, as it has been fully ex¬ plained in connection with the hygiene of respiration. Impurities of the Air. — The principal impurities of the air to which we shall call particular attention are as follows : — First, various gases, comprising carbon-dioxide or carbonic acid, carbonic oxide, ammonia, sulphureted hydrogen, and various noxious gases arising from the decomposition of organic matter, from render¬ ing establishments, chemical works, and other sources. Second, germs and other minute living bodies consisting of spores, animalcules, etc. Th ird, dust, consisting of minute particles of earthy matter, frag¬ ments of hair, fibres from clothing, minute portions of small insects, particles of decomposing matter, and a great variety of substances too numerous to mention. We will now notice more in detail some of the more important of these impurities and their sources. Carbonic Acid. — Of the various poisons which contaminate the air, carbonic acid, or, more properly, carbon dioxide, is the most abun¬ dant. While not the most dangerous, it may be considered as the 542 HYGIENE OF THE A IE, chief impurity of the air. It is produced by the burning of wood, coal, and all ordinary combustibles, by the respiratory processes of animals and plants, and by the decay or decomposition of organic sub¬ stances. It is also produced by various chemical processes, as the burn¬ ing of lime in lime-kilns. Carbonic acid is an invisible, odorless gas, a fact which adds to its dangerous character, since it makes it impos¬ sible to detect its presence by the senses. It is heavier than air, and hence has a tendency to accumulate in low places, as in unused wells, deep valleys, caves, and similar places. Some of the properties of Candle Extinguished by Carbonic Acid Gas. Fig-. iQO. Pouring Carbonic Acid Gan. this gas may be easily observed by making the following experiment : — Place in a deep glass jar — a two-quart fruit can will answer the purpose admirably — two heaping teaspoonfuls of bi-carbonate of soda or saleratus. Add a teaspoonful of water and allow the soda to dissolve. Now add a teaspoonful of strong vinegar. Immediately upon the addition of the vinegar a vigorous chemical action will occur, accompanied by great effervescence, the result of the liberation of car¬ bonic acid gas. In a few minutes the action will cease. Now, if a bit of candle be lighted and let down into the jar, by means of a wire, it will be extinguished almost as soon as it enters the mouth of the jar. (See Fig. 179.) This shows that the carbonic acid gas will not support combustion. Indeed, it is one of the best means of extinguishing fires, being employed for this purpose in the Babcock and other forms of ex- SOURCES OF CARBONIC ACID GAS. 543 tinguishers. That the gas is heavier than air is shown by the fact that it can be poured from one vessel to another, as also by the fact that when generated in the manner described it will remain for some time in the jar in which it is produced. While the jar is still full of gas, or before very much has been allowed to escape, raise it carefully to the mouth of another empty jar and perform the act of pouring exactly as though it were filled with water, as shown in Fig. 180. The fact that the carbonic acid has been poured into the jar may be shown by letting down into it a lighted candle as represented in the figure inferred to. The presence of carbonic acid may also be demonstrated in another manner. It is well known that chalk is a chemical compound of lime with carbonic acid. By pouring into the jar half a teaspoonful of clear lime and slaking thoroughly after placing a cover over the jar, the carbonic acid will combine with the lime, producing chalk, which will give to the water a milky or cloudy appearance. Lime-water is easily made by slaking freshly burned lime in water and allowing it to settle until clear. The clear solution may be turned off into another bottle, boiled, corked,- and preserved for use at any time required. The most important sources of carbonic acid in the air of dwelling- houses or other confined spaces occupied by human beings, where alone there is much danger from this gas, are respiration and the com - bustion of gas, oil, candles, and other illuminating substances. The presence of carbonic acid in the breath may be easily shown by a slight modification of the experiment described in the preceding par¬ agraph. Take a clean glass jar, and cover the mouth closely with writing-paper. Make two holes in the paper cover large enough to admit the end of the little finger. In one of these insert a glass tube or a large straw of sufficient length to reach to the bottom of the jar. Place the mouth at the other end and breathe into the jar for one or two minutes, taking care not to draw into the lungs any air from the jar. If a short piece of lighted candle be now let down into the jar as before immediately after removing the cover, it will be extinguished at once. The presence of carbonic acid in the jar may also be detected as in the previous experiment by putting into the jar a small quantity of lime-water, and shaking it for a few seconds. The production of chalk is indicated by the cloudy appearance, proving the presence of carbonic acid as before stated. The amount of carbonic acid produced by each adult person is 544 HYGIENE OF THE AIR. about one cubic inch at each breath, which would amount to twenty cubic inches, or about two-thirds of a pound, in a minute, or two-thirds of a cubic foot in. an hour. The ordinary oil-lamp produces about the same quantity of carbonic acid as a person. A good candle produces from five to ten times as much. Immense quantities of carbonic acid are produced in stoves, fire-places, and furnaces, but these we do not need to take into account, as it is conducted away with the smoke through the chimney. Carbonic acid is not so active a poison as many other gases with which the air is sometimes contaminated, but numerous experiments performed upon birds, mice, and other small animals, as well as upon human beings, have shown beyond the possibility of a doubt that it is directly poisonous to all forms of animal life even in small quantities. In the quantity in which it naturally exists in the atmosphere, — 3 to 4 parts in 10,000, — it is not injurious to animal life and is of great service as gaseous food to plants and all forms of vegetable life. If, however, its proportion be increased to G or 7 parts in 10,000, it be¬ comes decidedly prejudicial to health. This is true, however, only when it is produced by the respiration of animals or human beings, and is generally considered to be due more directly to the organic poi¬ son with which carbonic acid from these sources is always associated than from the carbonic acid itself. It has been shown to be true, however, that if pure carbonic acid from any source be added to the air in such quantity as to reduce the proportion of oxygen even as lit¬ tle as one-tenth per cent, or one part in a thousand, serious results will follow. Test for Carbonic Acid . — The most reliable authorities all ao;ree that the proportion of carbonic acid should never be allowed to be¬ come greater than 6 parts in 10,000 ; hence, it is important to be able to detect the presence of this gas, especially since, as before remarked, it cannot be readily detected by any of the senses. Fortunately, this may be accomplished by very simple means, the use of which requires only ordinary care. The materials required to perform the test are, a supply of perfectly clear, saturated lime-water, and four bottles or jars of different sizes, the sizes required being the following: one jar or bottle capable of holding exactly 16 ounces, or one pint; a second holding 10| ounces ; a third holding 8 ounces, or one-half pint ; and a fourth capable of holding 64 ounces. The jars should have necks large enough to admit of perfect cleaning of the whole inside, and the great- CARBONIC OXIDE. 545 est pains should be taken to remove every particle of dirt or dust from the inside as well as the outside, with water. To apply the test, till the jar with the air to be tested. This may be done either by draw¬ ing the air out of the bottle through a straw or tube, or by filling it with pure water and letting the water escape. Great care should be taken in sucking the air out of the bottle that the breath be not allowed to enter. To determine the amount of carbonic acid present, use the smallest jar first. After filling it in the manner described, pour in a large table-spoonful of clear lime-water. Close the mouth with a clean stopper and shake vigorously for a minute or two. If the lime-water becomes cloudy, carbonic acid is present in the air in the proportion of 10 parts to 10,000. If it does not become cloudy, repeat the ex¬ periment with the next sized jar or the half-pint jar. If the lime- water becomes cloudy in this, the proportion of carbonic acid is 8 parts in 10,000. This proportion may often be found in the rooms of dwelling-houses, and sometimes in crowded streets and narrow alleys. If the lime-water does not become cloudy in the jar of this size, the next size should be used in the same manner. The cloudiness appear¬ ing in this jar indicates the presence of 6 parts in 10,000. This is the largest proportion which may exist without actual danger to life. If no cloudiness appears without the employment of the largest jar, the proportion is only 4 parts of carbonic acid to 10,000 of pure air. Carbonic oxide, or more properly, carbon mon-oxide, is a gas closely allied to carbonic acid in its chemical composition, though very much more dangerous. This gas is produced only by incomplete oxidation. It is always found in the burning of coal in grates and stoves, but as it is a combustible gas, it is usually consumed, and so gives rise to no evil consequences. It is the burning of this gas which produces the blue flame characteristic of coal-fires. When the draft of a stove or range is seriously obstructed, this gas often finds its way into the air breathed by human beings. By its penetrating character it readily passes out of stoves seemingly air-tight through the minute cracks be¬ tween the different pieces of iron of which the stove is composed. It has been shown by experiment, also, that it passes with great facility through cast-iron when heated red-hot. This does not take place, however, so long as there is a sufficient draft, as that portion of the gas which escapes combustion is carried away with the smoke. When¬ ever the draft is obstructed, however, there is danger that this ex¬ ceedingly poisonous gas may find its way into the air and be taken 35 54G HYGIENE OF THE AIR. into the lungs. Carbonic oxide is also produced by gas-jets and lamps when turned down so low that incomplete combustion of the escaping gases takes place. The amount of gas which may be produced in this way is so great that serious consequences may result where ventilation is defective, as in sleeping in a close bed-room where the gas-jet or lamp is turned down very low, since it requires but an ex¬ ceedingly small proportion of this gas to produce serious effects. Or¬ dinary burning gas usually contains quite a large proportion of car¬ bonic oxide and it is undoubtedly the presence of this gas which causes the inhalation of coal-gas to produce such fatal results. Death is pro¬ duced by carbonic oxide by its paralyzing effect upon the blood-cor¬ puscles. It renders them incapable of absorbing oxygen, so that a person poisoned by it really dies of suffocation. To avoid danger of poisoning from carbonic oxide, the following suggestions should always be observed : First, avoid the use of close dampers in stoves or stove-pipes, and always secure a good draft from coal-grates ; second, never allow the fire-box of a heating furnace to become red-hot ; third, never allow gas-jets or lamps to burn when turned down so low that combustion is incomplete. The indication of the incomplete combustion of gas or oil is the presence of odors by which they are characterized and which may always be observed when a room is entered where a gas-jet or lamp turned low has been burn¬ ing for some time. Of the other poisonous gases which find their way into our rooms, the most injurious is sulphureted hydrogen, a gas which is always produced in the decomposition of animal matter. It has a very strong odor, — that of rotten eggs, and is very poisonous in character. It is present in sewer-gas, in the gas escaping from vaults, cesspools, barn-yards, and all emanations from decomposing animal excreta as well as from decaying animal bodies. The odor of car¬ rion is strongly laden with sulphureted hydrogen, and this is one of the most common sources of the gas, since small animals not infrequently secrete themselves in the open spaces underneath dwellings, when about to die. Chickens, cats, dogs, and other animals often die and undergo decomposition in such places. It is on this account very un¬ wise to use poison of any kind for the purpose of getting rid of rats and mice or other small animals. We have known instances to occur in which dwellings became almost uninhabitable from the eras arisino- from the decayed rats which had been poisoned and died between the walls and partitions, and in other inaccessible places. In the gutters, SULPHURIC ACID. 547 back streets, and alleys of large cities, this gas is sometimes produced in such enormous quantities that its chemical properties become per¬ ceptible, as well illustrated by the following anecdote which we heard related by a professor of chemistry in one of our State Universities : — “ A young lady who was entirely innocent of any knowledge of chemistry or chemical facts, emerged from an elegant mansion in New York City, fully equipped for an afternoon promenade, with face ar¬ tistically painted a la mode. Pier course, unfortunately, lay for a lit¬ tle distance through a portion of the city where the drainage was im¬ perfect, and the air was consequently redolent with that wonderfully pungent and active gas which is so characteristic of rotten eggs, — sul- phureted hydrogen. Of course the lady could not be unconscious of the presence of some noxious element in the atmosphere ; but she was, nevertheless, wholly ignorant of its chemical properties. Her igno¬ rance did not, however, deter the gas from manifesting its most vig¬ orous affinities for the lead paint upon her cheeks, of which she had abundant evidence as she stood before a mirror, upon her return home, and viewed the swarthy appearance of her countenance, which would have been very becoming to a representative member of the African race.” Ammonia is often present in the air arising from animal decompo¬ sition, its chief source being cesspools, vaults, and particularly stables and barn-yards. It is exceedingly disagreeable, but is not actively poisonous in such a degree as the other gases mentioned. Sulphuric acid is not infrequently present in the air, sometimes in considerable quantities in consequence of the combustion of coal, which always contains more or less sulphur, as well as from the burn¬ ing of coal-gas. The quantity of this acid produced in large cities where much coal is burned occasions the crumbling of brick and stone buildings, and in libraries it has often been known to destroy the leather binding of books exposed to its action, it being found not in¬ frequently that the binding of all the books on the higher shelves of the library become so brittle that rebinding is necessary. Complaint has also been made by wholesale dry-goods merchants in London that cotton goods and other fabrics stored on the upper shelves of high rooms and the upper stories of buildings, when kept on hand for some time, are injured to such an extent by the sulphuric acid produced by the burning gas as to become rotten and unsalable. There is no doubt but that the poisonous and irritating effects of 548 HYGIENE OF THE AIR. sulphuric acid produced in this way is a common cause of disease, af¬ fecting the air-passages. The evils arising from the vapors of this acid are now so well recognized that in large hospitals there is placed over each gas-burner a pipe for the purpose of conveying away the poisonous products of combustion. The evil is also remedied in some places by the use of gas produced by a mixture of gasoline vapor with air, a method which involves some inconvenience, but is recommended by its cheapness, its safety, the quality of the light produced by it, the absence of actively poisonous properties in the gas, and the entire ab¬ sence of active poisons in the products of combustion. This method of lighting has now been in use for more than two years at the Med¬ ical and Surgical Sanitarium, Battle Creek, Mich. Other noxious gases arising from chemical works, dye-houses, etc., are so seldom met with, or are so obviously injurious in character, that we do not need to mention them in detail. Fig-. 181. Atmospheric Germs Greatly Maguilied. Disease Germs. — Modern science has demonstrated through the aid of that wonderful little instrument, the microscope, that the most powerful of all the enemies to human life are those which are most insignificant in size. Through the researches of Pasteur, Tyndall, and other eminent workers in this field, it has been shown beyond a chance for question that the air which we breathe always contains in greater or lesser numbers minute living bodies known as germs. In Fig. 181 may be seen some of these minute organisms greatly magnified. As seen in the cut, they are simply roundish bodies, mixed with other bodies of various shapes, which are particles of dust as seen when greatly magnified. Wherever decay of either animal or vegetable matter has taken place, germs are developed and given off in great numbers. Mold from moldy bread, when placed under the microscope, may be seen to throw off into the air an immense number of minute particles termed spores, which are capable not only of giv- DISEASE GERMS. 519 ing rise to growths of mold, but is thought by scientists to be active in producing some forms of disease. Some so-called germs are ani¬ malcules, while others are germs of vegetable life. It is the presence of certain varieties of these little germs which occasions the fermenta¬ tion of beer, the “ rising ” of bread, the “ working ” of cider, and the “spoiling” of canned fruit and other preserved products, the “sour¬ ing” of milk, and all kinds of decay and decomposition. The condi¬ tions required for the growth and development of these minute organ¬ isms are warmth and moisture. In winter they are paralyzed by the cold, but as soon as the vernal sun appears, they spring quickly into life and activity. They are not affected by a very low temperature, and have even been known to withstand for hours a temperature con¬ siderably above that of boiling water. In the vicinity of cesspools, vaults, barn-yards, and other places where decomposition is going on, the air is heavily laden with these disease-producing agencies. Their office in the economy of nature seems to be to destroy bodies possessing higher forms of life, or, at any rate, to assist higher forms of organization to return to the inorganic or unorganized state. When the body is kept in a healthy condition, all its tissues possessing a high degree of vitality, it is unaffected by these agents of decay and death ; but so soon as the standard of vitality is lowered in any de¬ gree, or when the system is attacked by germs in great numbers, pos¬ sessing unusually active properties, we become a prey to their ravages and subject to a variety of maladies of the most fatal character. There seems to be at present little room for doubt that typhus and diph¬ theria, cerebro-spinal meningitis, malarial fevers, all of the contagious diseases, and perhaps a large number of others, the cause of which has not been so carefully studied, are produced by these agents. The presence of germs in the air cannot be very readily detected by any test which relates directly to them, but it may be safely considered that whenever and wherever foul odors are present, germs are also to be found, since these two sources of disease are almost invariably as¬ sociated together, having the same origin. It should be remembered, however, that germs may be present when foul odors are not, since they may be formed and given off be¬ fore a sufficient degree of decomposition has taken place to give rise to offensive gases. This fact should lead to the prompt removal of anything which is known to be a source of germs, since these minute and invisible bodies are far more serious in their effects upon the hu- 550 HYGIENE OF THE AIK. man system than any foul gas with which the air is ordinarily con¬ taminated. The mold upon the wall should be regarded with the gravest suspicion, and measures should be promptly taken for a re¬ moval of its cause. A musty odor is evidence of the presence in the air of spores thrown off by mold which may become the cause of seri¬ ous disease. Dust. — It is next to impossible to obtain air wholly free from dust. Its constant motion lifts and holds suspended little particles of various substances which are more or less injurious to health, unless the quan¬ tity is very small indeed. Some trades, as stone-cutting, coal-heaving, rag-picking, cotton and wool spinning and weaving, and other voca¬ tions which involve the production of considerable quantities of dust, expose the workmen to an atmosphere loaded with fine particles which are drawn into the lungs with every breath, and, finding lodgment there, may induce irritation and still more serious disease of those or¬ gans. By a wronderful provision of nature, as elsewhere explained, the finer particles of dust, if in small quantity, may be wholly re¬ moved so that they will not pass down into the more delicate air-cells of the lungs ; but if the quantity of dust is great, this provision fails to afford protection. The inhalation of dust is one of the causes of consumption. Post¬ mortem examination of the lungs of persons who had died from this cause showed the lungs to have acquired the color of the particles in¬ haled ; and, in some cases, they contained so large a quantity of sand that they felt gritty to the touch. Great care should always be taken to avoid dust as much as possi¬ ble. In sweeping carpets and dirty floors, a person is exposed to in¬ jury unless some precaution, such as sprinkling the floor or moisten¬ ing the broom, is taken to prevent filling the air with dirt. There are very few people who would not turn with disgust from food which was filled with particles of coal or sand, covered with dust, and gritty to the teeth. Yet the same persons will take their gaseous food in precisely the same condition without remonstrance. If necessarily exposed to dust for a time, danger from its inhala¬ tion may be avoided by applying over the mouth and nostrils a cotton¬ wool respirator, by means of which the air will be strained. A pocket- handkerchief will answer a very good purpose in the absence of a res¬ pirator. Organic Poison. — Gases, germs, and dust are most prolific sources of disease and death which attack man from the air ; but there is vet ORGANIC POISON. 551 another enemy of life more potent still, which lurks, too often unsus¬ pected, in the air we breathe. Very little, indeed, is known of the real nature of this poison, since it has, in considerable degree, eluded the efforts of the chemist to submit it to analysis; but it is of organic ori¬ gin, and hence is known by the term organic poison. This poisonous element is introduced into the air chiefly by means of respiration, to¬ gether with exhalations from the skin. It is one of the most noxious poisons ever present in air. It will produce death much sooner than most other impurities found in the air. Experiments have shown that mice and other small animals will die in a few minutes when confined in air heavily charged with this poison. The moisture which condenses on the inside of the windows of an occupied room in a cold day contains the poison in solution. If a little is collected in a vial and set away, it will soon become intensely fetid and offensive ; and when examined with the microscope it is found to be alive with vegetable growths and various animal forms. This poi¬ son also condenses on the walls and furniture of close, unventilated rooms, and a characteristic odor frequently emanates from them, and often clings to the clothing and bodies of persons living in them. This poison undergoes decomposition very rapidly, becoming foul and offensive in a few minutes. It is this which gives to an unventilated room the close, fusty odor with which every one is familiar. One who has been long in the room will not observe it ; but it is very distinct to a person coming in directly from the pure air outside. The amount of matter which is thus condensed upon and absorbed by plaster walls is much greater than is ordinarily supposed. Two causes operate to concentrate these fatally poisonous substances in the porous plaster walls of living-rooms of dwelling houses : first, the con¬ densation of the moisture of the breath on the walls, which are usually cooler than the atmosphere of the room ; second, the process which takes place through all porous walls, the inside air passing outward while the outside air is passing in. By these two processes such a large quantity is deposited that in the course of time the walls of the room may become highly charged with it. It is said that an ingenious Chinaman has discovered this fact, and that he finds it profitable to re¬ move all the plaster from his dwelling once in ten or fifteen years, re¬ placing it with new, using the old plaster to fertilize the soil. It is certainly well worth while to inquire whether it would not be wise for sanitarians to advocate the general adoption of this ( hinese cus- HYGIENE OF THE AIR. tom. We have no doubt it would be the means of saving a large amount of disease. The sovereign remedy for all evils resulting from the accumulation of the waste products of respiration, is, of course, thorough and efficient ventilation, the means for which will be pointed out under that head. Various Sources of Dangerous Gases and Disease Germs. — Under this head we shall notice various sources of air contamination which we have not yet referred to, or have barely mentioned, many of which are often the unsuspected causes of wide-spread and fatal dis¬ ease. Cellars. — Many families who wonder “ why some of the children are sick all the time ” can find the cause underneath the floor. Nearly all houses have cellars. Here are stored all sorts of things for winter use — dead things and live things, articles to eat and fuel to burn, old boxes and barrels, heaps of coal, bins of vegetables, etc., etc. The coal and wood are continually sending up foul gases. Many of the vegeta¬ bles undergo decay, and add greatly to the formation of disease-pro¬ ducing elements. Besides the cellar, there is usually an open space un¬ der the other portions of the house, between the foundation walls. In the country this space is often large enough to admit dogs, cats, pigs, and Other small animals, but not sufficiently large to allow room for cleaning it. Here various small animals find a hiding-place, and often die. Being out of sight and reach, they are not discovered even when the stench of their decaying bodies becomes distinctly manifest. All the foul gases engendered in these various ways pass upward into the house, filling every room, condensing in fetid moisture upon the walls, and poisoning all who breathe in the house. Cellars under houses are rather prejudicial to health, even at best. As they are commonly used, they are very greatly so. If there must be cellars beneath the house, they should be large, light, and well ven¬ tilated. Every week, at least, the cellar windows should be opened wide to allow free change of air. A good way to ventilate a cellar is to extend from it a pipe to the kitchen chimney. The draft in the chimney will carry away the gases which would otherwise find their way into the rooms above. Cellars should be kept clear of decaying vegetables, wood, wet coal, and mold. The walls should be frequently whitewashed, or washed with a strong solution of copperas. The importance of some of these simple measures cannot well be overestimated. MOLDY WALLS. 553 Houses should be built so high above the ground that the space beneath can be easily cleaned every few months. Moldy W.alls. — Many people who do not appreciate the impor¬ tance of sunshine as they should, allow mold and mildew to accumu¬ late upon their walls in damp weather, especially in nooks and corners that will be unobserved, never thinking that any harm will' come from so doing. Such are ignorant of the fact that each patch of mold is a forest of millions of little plants which are constantly throwing off into the air myriads of germs to be inhaled by the occupants of the house. There is good evidence for believing that the forms of leprosy described in the Jewish law as affecting the house were nothing less than certain forms of mold or fungoid growths which are especially liable to occur in warm countries like the land of Palestine. The de¬ scription of the so-called “ leprosy in the house,” together with the proper means to be adopted to remove the difficulty, may be found in Lev. 14 : 36-48 as follows : — “ Then the priest shall command that they empty the house, before the priest go into it to see the plague, that all that is in the house be not made unclean ; and afterward the priest shall go in to sec the house ; and he shall look on the plague, and, behold, if the plague be in the walls of the house with hollow streaks, greenish or reddish, which in sight are low^er than the wall, then the priest shall go out of the house to the door of the house, and shut up the house seven days ; and the priest shall come again the seventh day, and shall look ; and, behold, if the plague be spread in the "walls of the house, then the priest shall command that they take away the stones in which the plague is, and they shall cast them into an unclean place without the city ; and he shall cause the house to be scraped within round about, and they shall pour out the dust that they scrape off without the city into an unclean place ; and they shall take other stones, and put them in the place of those stones ; and he shall take other mortar, and shall plaster the house. “ And if the plague come again, and break out in the house, after that he hath taken away the stones, and after he hath scraped the house, and after it is plastered, then the priest shall come and look, and, behold, if the plague be spread in the house, it is a fretting leprosy in the house ; it is unclean. And he shall break down the house, the stones of it, and the timber thereof, and all the mortar of the house ; and he shall carry them forth out of the city into an un- 554 HYGIENE OF TI1E AIR. clean place. Moreover, he that goeth into the house all the while that it is shut up shall be unclean until the even. And he that lieth in the house shall wash his clothes ; and he that eateth in the house shall wash his clothes. And if the priest shall come in and look upon it, and, behold, the plague hath not spread in the house, after the house was plastered, then the priest shall pronounce the house clean, because the plague is healed.” Many have puzzled themselves much respecting the nature of the leprosy above described ; but when we consider the description given, in the light of modern sanitary science, the meaning is plain. The description answers exactly to certain species of mold which are apt to form on damp walls, being sometimes greenish and sometimes red¬ dish in color. The mold itself is not communicable to human beings, but as it grows it throws off into the air myriads of germs which give rise to fermentation and putrefaction, and when taken into the human system, to serious disease. The directions given for removing the evil are most excellent. If scraping off the mold and the plaster of the house and replastering did not exterminate it, the house ought to be torn down, for the recurrence of the mold would indicate that the conditions connected with the location of the house were such as to render it unfit to live in. How many leprous houses may be found now-a-days ! The green spots on the wall, the musty odor, and the damp, germ-laden air to be found in many a palatial residence as well as in the spare bedroom and dark parlors of the less pretentious cottages of people of more limited means, are symptoms of house leprosy which, three thousand years ago, would have consigned the infected dwellings to demolition. Are we thirty centuries behind Moses in our knowledge of, and obedi¬ ence to, sanitary law ? Privies. — As ordinarily constructed and managed, these necessary institutions are most prolific sources of disease. The animal excre¬ tions which are left to accumulate in them undergo still further putre¬ factive changes, which result in the development of the most pestilen¬ tial germs and gases. Here is where the terrible typhoid poison originates. Deep vaults should never be allowed under any circum¬ stances. The best way to manage a privy is this : Early in the spring fill up the old vault, if there is one, even with the surface. Raise the * building a little. Have made at the tin-shop a sufficient number of pails of galvanized iron. The pails should be of the form and size DRY- EARTH SYSTEM. odd Fig. 182. Pail for use with Dry-Earth System. indicated in Fig. 182. Each should be furnished with a long hail, and a strong handle at one side. In using these pails fill each half full of fine, dry dirt (not sand) or ashes, and shove it into position, as shown in Fig. 183. By the addition of a little dry dirt two or three times a day, all foul odors will be pre vented. The contents of the pails ought to be removed every night in the warmest weather of summer, the pails being replaced with a fresh supply of dry earth. During cooler weather, if little used, the pails will require emptying but once a week, if they are kept well supplied with dry earth. The contents of the pails may be buried or removed to a proper place at a distance from any dwelling or well. For convenience, it is found to be an excellent plan to hire a scavenger to attend to the pails at regular, stated times. Fifteen or twenty in a community can unite on the same plan, and thus make the expense very slight for each. We introduced this plan at the Battle Creek College, a large educational institution, as well as at the Sanitarium, wThere we have employed it for several years, and it has given perfect satisfaction from its first introduction. The same plan has, at our suggestion, been recently adopted by the trustees of another large edu¬ cational institution in this State. It has also been largely adopted in this city for the warm season of the year, with excellent results. 556 HYGIENE OF THE AIR. About the first of December, the pails may be removed and a shallow vault dug. The vault should not exceed two feet in depth and it should not be tightly inclosed. This will allow the contents of the vault to freeze. They may be removed several times during the winter, and should be kept covered with dry dirt, which should be procured in sufficient quantity lin the fall. Persons living in houses connected with sewers, as is customary in cities, incur great danger of injury from an exceedingly active agent of disease known as sewer-gas. Sewers are often unventilated, and become blocked up so that the confined gases find exit through the sinks, wash-bowls, bath-tubs, and water-closets of the houses with which they are connected. It is of the greatest importance that all connections with the sewers should be made air-tight, and should be guarded with traps of the most improved form, so as to make the en¬ trance of sewer-gas impossible. The sewer-pipes connected with the water-closets should be carried directly upward through the roof, and surmounted by a ventilating cap of the most improved form. This plan would ordinarily prevent any great danger from this source. Water-closets should be placed in a part of the building where they will not be likely to contaminate other rooms in the house, should they become foul. They should be thoroughly ventilated. Barn-yards, Hen-coops, etc. — The close proximity of barn-yards, hen-coops, and hog-pens to human dwellings is a frequent cause of serious and fatal disease. The germs which are developed in the filth abounding in those places, together with the noxious gases constantly arising from the decomposing excreta, are productive of disease when received into the system. Often, indeed, the well from which the family supply of water is obtained will be located only a few feet from a reeking barn-yard, or, as we have more than once seen, the well will, for convenience, be located within the yard itself. In consequence of the proximity, the water of the well will be contaminated by the soluble filth which percolates down through the porous earth and finds its way into the underground veins of water by which the well is fed. See Plate XVI. A few years ago a man came under our care at the Sanitarium suffering with what he supposed to be ague. Upon examination of his case, we very soon became convinced that his disease was typhoid fever instead, a view which was confirmed by the further history of the case. In less than a week, the son, a boy twelve or fourteen years Showing a not infrequent condition of affairs. The cesspool in close proximity to the cistern, contaminates it by the drainage of its foul contents through the porous soil, so that both become sources of disease and death. The well, located in the barn-yard for convenience, and near the privy vault, receives the foul drainage from both; while from the same foul source poisonous gases constantly arise and carry disease and death to the unsuspecting inmates of the house close by. Fig. 3. A condition very similar to that shown in Fig. 1, except that in this case the chief source of danger is the foul emanations from the cellar, vault, hog pen. and hen house. Plate XVI — INSANITARY CONDITIONS. % BARN-YARDS, HEN-COOPS, ETC. 557 of age, who was troubled with “ fits,” arrived, and his case also proved to be typhoid fever. In less than another week, the wife and mother joined the other members of the family, suffering, as she said, with the chills, hut, as we speedily found, with typhoid fever also. We placed the afflicted family in a cottage, with nurses, and in due time they were all convalescent, although they suffered very severely and were each exceedingly ill for several days. When the father, who first became convalescent, was just beginning to recover, we one day called upon him, when he began to reproach himself in the most bitter terms for his sickness and that of the other members of his family. He remarked that he cared less for the suffering he had endured and the expense he had incurred than he otherwise should but for the bit¬ ter consciousness that he was wholly to blame for it all, and ought to have known better than to allow the conditions to occur which occa¬ sioned the suffering. He then recited to us how, a year previous, thinking to increase his income somewhat, his wife proposed to raise a flock of chickens, and for her convenience a hen¬ house had been moved to within a few feet of the back-door During the few months previous to their sickness, three hundred chickens had been hatched and brought up in close proximity to the house, and the natural consequence was that the door-yard was in a condition little less repulsive than the most filthy pig-st}r. Foul gases were constantly arising and being carried into the house, together with countless numbers of germs. The process continued until the whole family were thoroughly poisoned, and much-abused nature finally manifested her resentment in a manner which was in the highest degree unpleasant and expensive, in more ways than one. We have no doubt that hundreds of cases of typhoid fever have been produced in a similar manner, and that people often look a long way from home for causes of disease which exist within the limits of their own premises. Notwithstanding all these dangers, there are people who, incredi¬ ble as it may seem, still hold to the absurd idea generated in the Dark Ages, when the streets of every city were one immense reeking cess¬ pool, that foul smells originating in the filthy ordure of horses and cows possess some healing properties. Not long ago, when we appealed to a man to clear his barn-yard, which had become a positive nuisance, being not more than half a dozen feet from the threshold of a dwell- ing-house, he retorted that he had always been informed, and as he 558 HYGIENE OF THE AIR. thought by good authority, that a barn-yard smell was the “ healthiest kind of a smell,” and was “ especially good for consumptives.” If there is such an absurd error prevalent, it ought certainly to be cor¬ rected. No foul, noxious odor can be of any possible advantage to the health. Barn-yards should be located at least forty or fifty rods away from the dwelling, and farther if possible. Brains and Cesspools. — Drains, sewers, and cesspools, connected with a house are often sources of serious disease. The kitchen sink is not infrequently the door through which the germs of disease silently creep into a household and develop into disease and death, the cause of which remains a mystery and is attributed to the inscrutable dealings of Providence. In the summer, draughts are produced in the room, which suck up the filthy gases which are formed in the cesspool' or sewer, through the drain pipe, — unless it is furnished with an efficient water-trap, which is not usually the case. In the winter, the gases of the cesspool are nat¬ urally warmer than the air above, and so they rise and find their way into the house, filling it with invisible poison, which is breathed, and thus taken into the blood, by every occupant of the dwelling. Thou¬ sands of valuable lives are annually sacrificed in this way. How shall this evil be remedied ? In cities, the problem is a difficult one, unless sewers can be replaced by the dry-earth system. In the country and in small towns, it is easily cured thus: — Make the cesspool some little distance from the house. Place in communication with it a ventilating flue sixteen or eighteen feet in height, and four to six inches in diameter, and surmounted by a ventilator. This will carry off’ the foul gases under ordinary circumstances, but it will sometimes be found inefficient ; hence, a water-trap should be formed in the drain-pipe, just beneath the sink, by bending the pipe so that it will retain con¬ stantly three or four inches of water. S^e Plate XV, and Fig. 184. Another good way is to connect the drain-pipe with the chimney or stove-pipedby means of a pipe of suitable size. This will secure ventila¬ tion of the drain, except when there is no heat in the chimney Another valuable precaution is this: Pour into the sink two or three times a week a gallon of water in which a pound of copperas has been dissolved. A few crystals of copperas kept constantly in the sink could Fig. l. The above cut is an illustration of a very common source of disease. At the left hand is shown a house, the inmates of which are being poisoned bv destructive gases (shown in blue) laden with disease germs which emanate from the cellar in which may be seen bins and barrels of decomposing vegetables, and the cesspool, tilled with the accumulations of years. The foul gases and germs from the cellar find ready access to the rooms above through the open cellar door, and from the seething cesspool they ascend to the house through the untrapped drain pipe which communicates with the sink. At the right hand may be 6een a house which is protected from cesspool contamination by means of a trap in the drain pipe. As will be seen, the foul gases, represented by the blue color, pass up through the ventilating pipe into the open air, instead of being drawn up into the house through the kitchen sink. Fig- *88 medicine everywhere teach at the present day doctrines quite opposed to those held by their predecessors. The artificial method is thus described by Prof. Jacob Bigelow, M. D., of Harvard University: “The destruc¬ tive tendencies of disease and the supposed proneness to deterioration of nature herself were opposed by copious and exhausting depletion fol¬ lowed by a shadowy array of alteratives, deobstruents, and tonics. The confinement by disease which might have been terminated in a few days was protracted to weeks and months; because the importance of the case required, as it was thought, that the patient should be ‘ taken down ’ mid then artificially ‘ built up.’ “ Artificial medicine undermined the strength, elicited new morbid manifestations, and left more disease than it took away. The question raised was not how much the patient had profited under his active treatment, but how much more of the same he could bear. Large doses of violent and deleterious drugs were given as long as the patient evinced * tolerance ’ of them, that is, did not sink under them. The results in such cases, if favorable, like the escapes of desperate surgery, were chron¬ icled as professional triumphs, while the press was silent on the disas¬ trous results subsequently incurred in like cases by deluded imitators. If diseases proved fatal, or even if they were not jugulated or cut short at the outset, the misfortune was attributed to the circumstance of the remedies not being sufficiently active, or of the physician not being called in season. A considerable amount of violent practice is still maintained by routine physicians who, without going deeply into the true nature or exigencies of the case before them, assume the general ground that nothing is dangerous but neglect. Edge-tools are used as though they could never be anything more than harmless playthings. It is thought allowable to . harass the patient with daily and opposite prescriptions; to try, to abandon, to re-inforce, or reverse; to blow hot and cold on successive days; but never to let the patient alone nor in¬ trust his case to the quiet guidance of nature. Consulting physicians frequently and painfully witness the gratuitous suffering and continued nausea, the prostration of strength and prevention of appetite, the stupefac¬ tion of the senses and the wearisome days and nights which would never have occurred had there been no such thing as officious medication. What practitioner has not seen infants screaming in the pangs of hun¬ ger, or of stimulants remorselessly applied to their tender skins, and Avhose only chance for relief was in the continued routine of unnecessary calomel and ipecacuanha.” EXCLUSIVE METHOD. 58D The same author further states that blisters, antimonial ointments, insalivation, etc., may continue to afflict the patient long after the dis¬ ease is gone. The effects of powerful depletion are felt for months, and sometimes for years. “ The enormous polypharmacopoeia of modern times is an excrescence on science, unsupported by any evidence of ne¬ cessity or fitness.” A few more extracts from eminent members of the profession may not be uninteresting. Prof. Gilman, M. D., of the New York College of Physicians and Surgeons, says, “ A mild mercurial course and mildly cutting a man’s throat are synonymous terms.” John Mason Goode, M. D., F. R. S., author of “ Goode’s Study of Med¬ icine,” says, “ The effects of our medicines on the human system are in the highest degree uncertain, except, indeed, that they have destroyed more lives than war, pestilence, and famine, combined.” Exclusive Method. — Under this head are, included all of the vari¬ ous medical sects which have claimed to be able to cure all diseases by a single method or by the employment of one or a few remedies. The method comprises Homeopathy, Hydropathy, Eclecticism (in the usual application of the term), Physio-medicalism, and many others too numer¬ ous to mention. Many patent nostrums and secret remedies are in¬ cluded under this class, claiming, as they do, to be panaceas for all the ills which flesh is hen- to. Each one of the exclusive systems undoubtedly contains elements of truth, some presenting much truth and little error, others much error and very little truth. All, however, embody the fundamental error that dis¬ eases may be cured by the application of some one principle or a few rem¬ edies. Homeopathy has, undoubtedly, acomplished a great amount of good in demonstrating that in a large share of cases, at least, extremely minute or infinitesimal doses of medicine are as efficient if not more use¬ ful in the treatment of disease than the huge doses and “ heroic ” prac¬ tices almost universally in vogue at the time when homeopathy came into existence. It is not remarkable that the wide contrast between its small doses and palatable medicaments and the vile, nauseating mixtures employed in the artificial method should have won for it a large follow¬ ing and increased popularity, even at the present time when it is well known that not more than one in a hundred of the so-called homeopathic physicians believe or attempt to practice the principles enunciated by the founder of the system. So, also, hydropathy has accomplished a work for which the world has not yet learned to be sufficiently grateful, al- 590 RATIONAL REMEDIES FOR DISEASE. though the present indications are that the whole system, stripped of its exclusive character, will be grafted upon all other systems of practice alike. In its exclusive form, hydropathy has doubtless done much harm. We cannot believe, however, that, notwithstanding all the ignorance and fanaticism of some of the earlier advocates of the “ cold-water cure,” one-tenth as much harm has been done by this exclusive method of prac¬ tice as by the artificial methods of treatment before described, which, according to Dr. Coggswell, of Boston, have been “ productive of vastly more evil than good,” and which, according to the eminent Dr. Rush, of Philadelphia, have not only “ assisted in multiplying diseases,” but also “ increased their fatality.” Electro-therapy, like hydropathy, originated with men whose views of medical science were limited and inaccurate ; and its failure to accomplish what was claimed for it as an exclusive remedy, brought it, like hydropathy and all other exclusive remedies, into disrepute with the more enlightened part of the profession. Through scientific investigation, however, both electro- therapy and hydro- therapy, or hydriatics, have been placed upon a rational basis, and have thus been shown to contain a large proportion of truth in spite of the many erroneous notions and properties connected with them by their earlier advocates. The Expectant Method. — The unfavorable results of the artificial method of treatment, and the uncertain and often disappointing results of the exclusive methods, have given rise to a great amount of skepticism on the part of many observing people respecting the merits of all modes of treatment, out of which has grown what may be termed the Expectant Method of treatment, which consists in simply giving to the patient good care and nursing, withholding all active measures of treatment in the be¬ lief that every case of disease is either incurable or has a direct tendency toward recovery ; and that all remedies are clearly useless in averting death or shortening the duration of human maladies. This method has never attained to any very great popularity, and never can secure a large number of followers, since it is directly opposed to the popular notion of disease and the almost universal belief in the efficacy of remedies. Even those who have been when in health its warmest supporters, when them¬ selves suffering with serious disease, have nearly always deserted then- favorite theory and resorted for relief to the same measures as those of less skeptical tendencies. The expectant method of treatment has, how¬ ever, in the cases in which it has been employed, demonstrated beyond room for question that certain diseases at least have a natural tendency THE EXPECTANT METHOD. 591 to recovery, and are influenced by remedial measures in a much smaller degree than has been almost universally supposed. Numerous experi¬ ments in the expectant treatment of various maladies have been made in various European countries and also in this country, and in not a few instances experimenters have declared that the results obtained when no active remedial measures were employed were equally good with those ob¬ tained from the most active medication. It is to be said, however, with reference to those experiments, that the expectant method has usually been compared with a mode of treatment closely allied to, if not identical with, that described as the artificial method; and hence it is not surpris¬ ing that the patient when left to himself with no attention except proper care and nursing has suffered less, and made a more rapid recovery, than when tormented by various irritating and depressing agents applied with an idea of combating the morbid entity at work in his organism. Al¬ though this method of treatment has sometimes been described as “a meditation on death,” yet it must be said in its favor that if the choice were between it and the old-fashioned artificial method of practice be¬ lieved in by our forefathers and still to some extent in vogue, the prefer¬ ence would be decidedly in favor of the expectant method. On this point Dr. Jacob Bigelow, president of the American Academy of Arts and Sci¬ ences, and professor in the medical department of Harvard University, hi a work published a few' years ago, stated as his sincere belief that “ the unbiased opinion of most medical men of sound judgment and long ex¬ perience is made up that the amount of death and disaster in the world would be less if all diseases wrere left to themselves than it now is under the multiform, reckless, and contradictory modes of practice, good and bad, with which practitioners of diverse denominations carry on their differences, at the expense of their patients.” Said Sir. John Forbes, M. D., F. It. S., “ Some patients get well with the aid of medicine, more without it, and still more in spite of it.” Says the Dublin Medical Journal, “Assuredly the uncertain and most unsatisfactory art that vTe call medical science is no science at all, but a jumble of inconsistent opinions, of conclusions hastily and often in¬ correctly drawn, of facts misunderstood or perverted, of comparisons without analogy, of hypotheses without reason, and of theories not only useless but dangerous.” Said Dr.Bostwick, author of the “ History of Medicine,” “Every dose of medicine given is a blind experiment on the vitality of the patient/' Said James Johnson, M. D., F. R. S., editor of The Medico-chirurgical 592 RATIONAL REMEDIES FOR DISEASE. Review, “ I declare as my conscientious conviction founded on long ex¬ perience and reflection, that if there was not a single physician, surgeon,, inan-midwife, chemist, apothecary, druggist, nor drug, on the face of the earth, there would be less sickness and less mortality than now prevail.” Prof. J. W. Carson, of the New York College of Physicians and Surgeons, says, “We do not know whether our patients recover because we give them medicine or because nature cures them. Perhaps bread- pills would cure as many as medicine.” The eminent Dr. Alonzo Clark a professor in the same medical college, states that “ in their zeal to do,, good, physicians have done much harm; they have hurried many to the crave who would have recovered if left to nature and that “ all of our curative agents are poisons, and, as a consequence, every dose dimin¬ ishes the patient’s vitality.” Prof. Martin Paine, of the New York University Medical College, asserts that “drug medicines do but cure one disease by producing another,” a sentiment which is also sustained by the testimony of the late Prof. Liebig, the well-known German chemist. Prof. Samuel G. Armor, of the Long Island Hospital, in a lecture before the Association of Physicians, in Brooklyn, said, “ Drugs are ad¬ ministered, patients recover, and we suppose that we have cured them, whereas our remedies have had little or nothing to do with recovery ; very likely it took place in spite of our drugs.” Dr. Oliver Wendell Holmes, the well-known “ Autocrat of the break¬ fast table,” has asserted that mankind would be infinitely better off if all drugs were cast into the sea, but adds that such a procedure would be “bad for the fishes.” Rational Medicine. — The outgrowth of scientific investigation of the nature and causes of disease and the relations to the human body of the various external agents which may be brought in contact with it, has been the development, out of the chaos and confusion of the “ war of the pathies,” of a method of dealing with the human system when subject to disease known as the Rational Method. This system recognizes no universal remedy for disease and no universal law of cure. It confines itself to no one order or class of remedies or meth¬ ods. It includes and recognizes all useful remedial agents, no matter when, how, or by whom discovered, which have been by experience proven to be of real value in the treatment of disease. It avoids ex¬ clusive systems and ideas, but accepts all that is really valuable in all. It is in the fullest and truest sense eclectic in character. Its princi¬ ples may be concisely stated as follows: — RATIONAL MEDICINE. 593 1. Nature alone possesses the power to heal. 2. Any agent which will assist nature in effecting a cure is a re¬ medial agent, and may, under proper circumstances, be used as such. 3. Remedial agents affect the system beneficially, not through their own operations upon it, but through the reactions of the living tissues upon them. 4. All remedial agents involve in their application the expenditure of the vitality of the patient, some more, some less. 5. The best remedies are those which will render the most reme¬ dial aid with the least expense to the vitality of the patient. 6. Patients, not diseases, are to be treated. 7. There is in nature no antidote for the results of the transires- sion of physical laws. Upon these few principles all true medical philosophy and prac¬ tice are based ; and the success or want of success of any particular method of treatment wholly depends upon the degree to which these principles are recognized and applied. In order to render them more intelligible to non-professional readers, for whom principally we write, we will consider each of these principles more at length. 1. Nature alone possesses the power to heal. — That the true heal¬ ing power resides in nature is established by a great number of facts, many of which are admirably presented in a work by Sir John Forbes, editor of the British and Foreign Medical Review, entitled, “Nature and Art in Disease.” The author clearly proves that nature is the real healing power by the following facts, which he ably presents : — • (1) Wild animals- suffer the most serious injuries and are fre¬ quently affected by epidemic diseases, and yet recover without artifi¬ cial aid. The same is true of domestic animals in a somewhat less de¬ gree, since they are sometimes subject to medical treatment. It is suggested, however, that such treatment as is usually employed has no effect whatever, or is detrimental rather than beneficial. Such treat¬ ment as placing in the stall of the sick animal branches of the wych- elm, tying to its tail colored threads, or making a slit in the sick creat¬ ure’s ear with a pair of rusty scissors, could certainly have very little curative effect. (2) Among savages and semi-civilized nations, medical treatment is either not employed, or consists of such absurd procedures as could not possibly be of any benefit, consisting in many cases of charms, in¬ cantations, and other measures equally harmless to produce any appre¬ ciable effects. 38 594 RATIONAL REMEDIES FOR DISEASE. (3) Many cases have occurred in which persons have suffered with serious maladies, such as fevers and other acute diseases, when isolated or otherwise unable to obtain medical advice, and yet have made excel¬ lent recoveries. (4) Many experiments have been made by physicians in different countries in the treatment of diseases by inert remedies for the pur¬ pose of studying the natural history of disease. In many cases, re¬ sults have been so favorable as to give rise to the gravest skepticism as to the efficacy of remedial measures. The writer mentions the case of a celebrated professor, who, on being told that a new sect had sprung up — the homeopathists — which cured diseases by infinitesimal doses of medicine, replied that he had long been in the habit of doing more than this ; namely, curing diseases by none. At the present time there are very few eminent physicians who do not hold to this view, and it is probable that there can scarcely be found anywhere an intel¬ ligent physician who would attempt to defend the strange and absurd views of Cumming on this point, who is said to have exclaimed in his lecture-room, “ As for nature, I would treat it in the sick-room as I would a squalling cat, — open the door and drive it out but it is not doubted that the following of such pernicious teaching has given rise to a large share of the erroneous, unscientific, and unsuccessful med¬ ical practice of the last century. 2. Any agent which will assist nature in effecting a cure is a reme¬ dial agent, and may, under proper circumstances, he used as such. — As before remarked, the rational method is wholly opposed to exclu¬ sive treatment. It accepts any remedy which experience has shown to be of real value in the treatment of the various maladies to which mankind is subject. The proper test for any method or plan of treat¬ ment proposed is, “ Will it aid nature in restoring a sick person to health ? ” If this question can be answered in the affirmative, this remedy may be employed, no matter how when or where it was orig¬ inated or discovered. 3. Remedial agents affect the system beneficially, not through their operations upon it, but through the reactions of the living tissue upon them. — This proposition, although directly opposed to the notions generally entertained by non-professional people, is abundantly sus¬ tained by scientific evidence. The contrary view, namely, that reme¬ dies operate directly upon the system, originated in the erroneous view’s of the nature of disease, which supposed it to be an entity of RATIONAL MEDICINE. 595 some sort to be attacked and driven out by energetic measures. This fallacious view, having been entertained at a time when many of the current expressions relating to disease and its treatment were being formulated, has been perpetuated by them ; and it is probably due to this fact that it is so extremely difficult to uproot from the popular mind, and even from the average professional mind, the absurd doc¬ trines which were long since exploded by scientific investigation. A thorough understanding and ready acceptance of this proposition is insured by a knowledge of the properties of vital or organized tissues and the relations of inert or inorganic matter to organization. A few illustrations may be necessary to make this point perfectly clear to the ordinary reader. We will begin with examples of the simplest kind and proceed from them to more complex examples. Food is said to nourish the body. The expression with reference to it apparently supposes that the food is the active agent and that the body is acted upon by it ; yet the most superficial study of the process of nutrition clearly demonstrates that the body alone, with its organs, is the active agent, the food being wholly passive. When re¬ ceived into the body, the food is subject to processes of digestion, in which it does not act, but is acted upon by the teeth, stomach, intes¬ tines, and various digestive juices which come in contact with it. After being reduced to a fluid condition it is still further acted upon, beinor absorbed and thus received into the blood, from which it is taken up by the various vessels, carried into various parts of the body and converted into tissue, and thus utilized. Through the whole process the food is acted upon, not in a single instance appearing otherwise than as a wdiolly passive substance. Water, one of the most impor¬ tant elements of nutrition as well as a powerful remedial agent, when taken into the system is acted upon by the blood-vessels, tissues, and various other parts of the body, and thus made to subserve useful ends, but in no instance does it act upon living parts. The same may be said respecting air. It is received, absorbed, assimilated, and finally expelled from the body in connection with carbon, a waste product. It, too, is wholly passive. Now let us observe that the same relation exists between the liv¬ ing tissues and remedial agents which may be applied to them. Let us suppose, for instance, that a person swallows some substance which is said to act as an emetic. When received into the stomach it is recognized as something which cannot be utilized, and as obnoxious to 598 RATIONAL REMEDIES FOR DISEASE. the tissues. The inherent tendency of the body to maintain itself in a normal condition by keeping its various parts free from obstructions and irritating elements, occasions the action of the stomach and acces¬ sory parts upon the foreign substance received, which results in its expulsion. The feeling of nausea which precedes the expulsory act is an expression of the repugnance of the system for the obnoxious substance received, and the expulsory act known as vomiting, which is said to be the effect of the emetic, is evidently nothing more nor less than a vigorous effort on the part of the system to rid itself of the irritating and unusable substance. Any substance which is thus treated by the stomach is called an emetic. The substances rejected in this manner by the system are said to possess emetic properties, although it is evident from the facts to which we have just called attention that the emetic properties, so-called, are due to the manner in which the substance is recognized by the system, rather than to any action upon the system by the emetic substance. In like man¬ ner, we may easily see that substances called diuretic are simply those which occasion an increased action on the part of the kidneys by being expelled by them. Scientific physicians understand this fact perfectly well, though for convenience in referring to diuretics, they speak of the drug as though it acted on the kidneys. Many persons undoubtedly believe that sweet spirits of nitre, juniper, and other well-known diuretics, act upon the kidneys, but scientific physicians entertain no such idea. A cathartic is a drug which is expelled by the intestines. Any substance which occasions an increased activity of the skin, or per¬ spiration, is called a diaphoretic. If we should consider each one of the properties of different medicines or remedial agents, we should find that in each case the medicinal property, so-called, is expressive of the manner in which the system acts toward the remedy rather than any action of the remedy itself. The remedy which occasions only one kind of action has one property, while a remedy which occasions numer¬ ous actions or disturbances in the body possesses many properties. It is important that this point should be clearly understood and al¬ ways kept in mind in the application of remedies in the treatment of disease, as many serious errors in practice may thus be prevented. 4. All remedial agents involve in their action an expenditure of the vitality of the patient, some more, some less. — This proposition fol¬ lows as a natural result from the preceding. While a person receives RATIONAL MEDICINE. 597 strength and nourishment from the digestion of food, it is nevertheless true that vitality is expended in the process of digestion. So with all of the other nutritive processes. In the circulation of the blood, in respira¬ tion, and all other vital actions, vitality is being constantly used up or expended. An agent which increases any of these actions necessarily increases vital expenditure. 5. The best remedies are those which ivill furnish the most re¬ medied aid with the least expense to the vitality of the patient. — It would need no argument to convince a merchant that he would derive the most profit from the sale of goods for which he could obtain the highest price and which he could purchase at the lowest figures ; or the farmer that he would derive the greatest gain by raising crops for which he could obtain the largest pecuniary returns with the least out¬ lay of money and labor in raising. It is equally evident that the best remedies to use in the treatment of the sick are those which will secure the desired results with the least expenditure of vitality on the part of the patient. What these remedies are we shall point out in another con¬ nection. 6. Patients, not diseases, are to be treated. — To some, this propo¬ sition will appear absurd, while to others it will appear equally unnec¬ essary. That the proposition is neither absurd nor superfluous is abundantly proved by the most casual examination of the many modes of treatment which have been in vogue during the past, as well as some of those still employed to a greater or less extent at the present time. Not a small proportion of the average practitioners, when called to see a patient, in considering the symptoms of the case and the indications for treatment, consider less the patient himself than the name and nat¬ ure of the disease with which he is suffering. It is a common custom with many non-progressive phj^sicians, and with the laity almost alto¬ gether, to treat diseases by their names. If a person is suffering from any given disease, he is at once advised to take some remedy which is said to cure that disease. The particular remedy prescribed will depend largely on the prevailing fashion at that particular time or place, fft is, in fact, the disregard of the principle above stated which has led to what are termed fashions in medicine, the existence and evil results of which are fully recognized by the more intelligent physicians everywhere. It has not infrequently happened — indeed, we believe occurrences of the sort to be more common than we would dare to suggest — that some acute or chronic diseases have been treated with the result of successfully curing 598 RATIONAL REMEDIES FOR DISEASE. tke disease, but with equal success in destroying the patient. “ Cured to death,” might justly be written upon many a tombstone placed over graves whose occupants were said to have died of various maladies which were far less responsible for their death than was the “ heroic ” treatment to which they were subjected. Nothing can be more unscientific, or more unsatisfactory in its results, than the ordinary routine of “ treat¬ ing ” diseases. Any plan of treatment, to be successful in aiding nature in the relief of human suffering and the prolongation of human life, must regard the conditions and interests of the patient, rather than the name or nature of the disease from which he is suffering. We need not delay longer upon this point as it will be reverted to at greater length elsewhere. 7. There is in nature no antidote for the results of the transgres¬ sion of physical laws. — This proposition, too, will doubtless be warmly disputed, especially by those who imagine that all existing things were made for the special benefit or advantage of man, and that everything may, by proper investigation, be made subservient to his interests. We believe, however, as was remarked to us by the learned editor of one of the leading medical journals of the West, that “ there is no more danger¬ ous popular error than that it is possible for a person to violate ad libi¬ tum the laws which relate to his physical well-being, and then avert the natural penalty of his transgression by swallowing a few doses of med¬ icine, or by resorting to any other remedial measure.” Remedies may postpone, for a time, the results of physical transgression, and may even seem to prevent them altogether, but careful observation will show that the escape from punishment is only apparent. Its form may be mod¬ ified, but it cannot be averted entirely. A person who squanders his vital force will certainly die prematurely. If his career is not cut short by some acute malady, he will be worn out by some chronic disorder. Rational medicine teaches that every physical transgression must be visited by commensurate punishment, and that the proper work for the physician is to instruct people how to escape the penalty of trans¬ gression, not only by averting the penalty after the liability to it has been incurred, but by giving warning, by proper instruction, of the cer¬ tainty with which suffering and possibly death result from a disregard of nature’s laws, and thus preventing transgression. HYGIENIC AGENTS. 599 THERAPEUTIC AGENTS OR REMEDIES FOR DISEASE. We are now prepared to enter upon the consideration of the differ¬ ent classes of therapeutic agents which are or may be employed in the treatment of disease. In considering this subject we shall endeavor to point out the excellences or disadvantages of each class, and shall give special preference and prominence to those remedies which are partic¬ ularly adapted to the use of non-professional persons, touching very lightly those agents which should be employed, if at all, only by the trained physician. In this consideration we shall divide all remedies into two classes, under the respective heads, “ Hygienic Agents ” and “ Medicinal Agents.” HYGIENIC AGENTS. Under this head we shall consider the remedial properties and ap¬ plications of water , air, light, heat, electricity, exercise, food, and mental influences. These agencies are termed hygienic, because they are not only useful in disease in aiding in the restoration of health, but are also essential to the maintenance of life and health at all times. Of all the remedies employed in the treatment of disease these are the most important, and will receive first attention for the following reasons : — 1. Because a great share of the maladies to which human beings are subject arise from disturbances in the relations of these agents to the human system, which only need to be regulated to effect a cure of the disease. 2. Because they sustain to the vital organs friendly rather than hostile relations, and harmonize with its processes in a most admirable manner. 3. In consequence of these facts the remedies comprised in this class are those which are least expensive to the system, since they will accomplish the results desired with the least expenditure of vitality. On this account they are to be recommended above all others, and should be employed to the exclusion of all others when accessible, and when they are capable of meeting the requirements of the case in hand. That we are not alone in this view of the merits of hygienic remedial agents, or hygeio-therapeutics, we might show by numerous 600 RATIONAL REMEDIES FOR DISEASE. references to the teachings of eminent medical instructors, were it nec¬ essary ; but so general has the admission of this truth become, that we need not weary either ourselves or our readers with quotations upon the subject. One or two references will suffice as illustrations of many. “ It is the duty of the physician to restore health by the simplest means in his power.” — Prof. S. G. Armor, M. D., of the Long Island Medical College. “ Hygiene is of far more value in the treatment of disease than drugs.” — Prof. Willard Parker, of the New York College of Physicians and Surgeons. Let us now consider in detail the merits and modes of application of each one of these agents. WATER. In order to understand the relations of water to the system as a remedial agent we must become acquainted, in some degree at least, with its physical properties. Water exists in three states; viz., as a solid, in the form of ice ; as a liquid, its most common form ; and as a vapor, in the form of steam. When in the last condition, the gaseous, it is invisible. That to which the term steam is very commonly ap¬ plied, is not steam, but water in a state of fine division, or mist. Below 32° F., pure water exists in the form of ice. Between 32° and 212°, it is a liquid. At 212° it is converted into vapor. Water slowly evaporates at all temperatures below 212°, being absorbed and held in solution by the air. Water possesses the greatest specific heat of any substance. By specific heat is meant the actual amount of heat required to elevate its temperature a given number of degrees. For example, it requires ten times as much heat to raise a pound of water 1° in temperature as to elevate a pound of copper 1° in temperature. To raise the tem¬ perature of a pound of lead 1°, requires only one-thirtieth as much heat as to produce the same effect upon a pound of water. Water ab¬ sorbs more heat by elevation of temperature than any other substance. In passing from the solid to the liquid state, it absorbs a vast amount of heat without any elevation of temperature. The same thing occurs in the conversion of water into steam or vapor by evaporation. In the evaporation of one pound of water, as much heat is absorbed, or rendered latent, as would suffice to raise nearly a thousand pounds of water one degree in temperature. This heat is abstracted from sur- PHYSIOLOGICAL EFFECTS OF WATER. 601 rounding objects ; and, hence, evaporation is one of the most powerful means of producing cold. The effect is the same, no matter what the temperature at which evaporation occurs. Water is not the best conductor of heat, but it conducts much more readily than air, and readily communicates its heat to bodies with which it comes in contact, also abstracting heat when of a lower temperature, when changing from a solid to a liquid state, or from the liquid to the gaseous condition. One of the most useful properties of water is its power to dissolve numerous substances, its solvent properties being nearly universal. To this property it owes its value as a cleansing agent, as also its value as a means of aiding nutrition by dissolving and circulating the nutritive elements required for the sustenance of the body, and wash¬ ing away from the tissues the waste products resulting from their activ¬ ity. It is also through its solvent properties, as we shall show, that some of its most important remedial applications are attributable. The Physiological Effects of Water. — The effects of water upon the human system are the results of the operation of its phys¬ ical properties in conjunction with the vital forces. As with all other agents, its effects may be either local or general, according to the mode of application. Different effects are also produced, according as the administration is internal or external. Many other modifying circum¬ stances, as age, sex, and physical condition, affect the results in a greater or lesser degree. Water affects the system through three different means ; viz: — 1. As a diluent. 2. By its solvent properties. 3. By modifying the general or local temperature of the body. 1. Water as a Diluent. — Water is received into the system by absorption, either through a mucous membrane, or through the skin. It usually enters through the medium of the stomach and intestinal canal. When received into the blood, it of course increases its volume, and produces an increased fullness of the circulatory vessels, which are never distended to their fullest extent, and hence allow room for change in the volume of their contents. The blood is necessarily ren¬ dered more fluid, and if previously in any degree viscid its circulation is quickened by its dilution. Hence it is of great importance that care should be taken to supply the blood with a sufficient quantity of fluid. This is especially necessary during the hot season of the year, when 602 RATIONAL REMEDIES FOR DISEASE. the blood loses its watery portion quite rapidly through profuse per¬ spiration. It is also important to be remembered by those who are exposed to extreme artificial heat, as is .the case with glass-blowers furnace-men, stokers, etc. 2. The Effects of the Solvent Properties of Water. — With the exception of air, water is the most transient of all the elements re¬ ceived into the body. It is eliminated by the skin, the lungs, the kid¬ neys, and the intestines. By its solvent action, it dissolves the various poisonous products of the disintegration of the tissues. The volume of the blood being increased, more water comes in contact with the debris contained in any part, and, in consequence, the same undesirable prod ucts are more perfectly removed. The increased amount of excremen- titious matter in solution is brought in contact with the various depu¬ rating organs, producing, notably, the following results: — a. An increase of the urinary excretion. It is an important fact that this increase does not consist in the addition of water merely, or di¬ lution, but that there is also an increased amount of urea, the chief ex- crementitious principle removed from the blood by the kidneys. b. An increase in the cutaneous excretion. Water-drinking is one of the most efficient means of producing copious perspiration; which, as with the urinary excretion, is not a mere elimination of water, but is a real depurating process. c. An increase in the action of the liver. Experiments made with every care to avoid the possibility of error, by the most eminent scientists and physiologists, show that the drinking of water is one of the most efficient means of increasing the activity of the liver, increas¬ ing not only the quantity of bile formed, but the amount of solid mat¬ ter secreted and excreted. d. Increased action of the intestinal mucous membrane. Elimi¬ nation from the mucous membrane of the intestinal canal, which Is an important organ of excretion, is also increased by drinking freely of pure water. The result of this increased action is not only to remove from the blood some of its foulest constituents, but to render more fluid the contents of the intestines, and thus tend to obviate that almost universal accompaniment of sedentary habits, constipation. The removal of clogging matters from the system in this manner al¬ lows greater freedom of vital action, so that the activities of the body are quickened, and both waste and repair, disintegration and assimila¬ tion, are accelerated. EFFECTS OF MODIFICATION OF TEMPERATURE. 603 I he use of water thus hastens all the vital processes by increasing the change of tissue. This result is, of course, chiefly obtained by em¬ ploying it as a drink. The experiments of Liebig fully confirm this view. He expressly mentions the free use of water as one of the means of accelerating vital change. Prof. John B. Biddle, M. D., hi his “ Ma¬ teria Medica,” states that “ it promotes both the metamorphosis and con¬ struction of tissue,” from which fact he attributes to it valuable curative properties as an alterative, when the removal of a morbid taint is de¬ sired, as in certain venereal diseases. Numerous other observers and experimenters attribute to water the same effects. It has also been noted that not only eliminative but assimilative processes are facilitated by the free use of water internally, and even in greater degree, so that those who drink water freely as a therapeutic means, usually increase in weight. The greater purity of the blood and the more perfect removal of obstructions, facilitates tissue formation and repair. 3. Effects Resulting from the Modification of Temperature. — Perhaps the most important, certainly the most common, effects of water upon the living organism are those which result from its modifications of the temperature of the body in its various modes of application. These effects vary greatly, according to the temperature and the dura¬ tion of the application. General and local applications also differ in their results. All of the effects of water are chiefly the results of the vital re¬ sistance of the system in its attempts to remove abnormal or unusual conditions, or to accommodate itself to new circumstances. Baths are divided into six classes, according to their temperature, as follows: — 1. Cold, . 33° to 60° F. 2. Cool, . 60° “ 70° “ 3. Temperate, .... 70° “ 85° “ 4. Tepid, . 85° “ 92° “ 5. Warm, . 92° “ 98° “ 6. Hot, . 98° “112° “ For the sake of simplicity, we will consider the effects of water ap¬ plications under three heads, viz., cold, warm, and hot. The Cold Bath. — Under this head we will consider applications of all temperatures below 85° F. Cold or cool water, applied to any portion of the body, causes instant contraction of the small arteries of the part, through its influence upon the sympathetic or vaso-motor system of nerves. So long as the application of the unusual temperature is con- G04 RATIONAL REMEDIES FOR DISEASE. tinued, the vascular contraction is maintained, and the part seems nearly bloodless. If the cold is below 33° F., and is long continued, destruction of the tissues by freezing will rasult. If a moderately cool or cold temperature is maintained for some time, the blood-vessels of the part are more or less permanently con¬ tracted, and the blood supply thus lessened. If, on the other hand, the application is very brief, the contraction of the vessels is only moment¬ ary, and is followed by a proportionate degree of relaxation, and a cor¬ responding increase in the supply of blood to the part. A very cold bath applied to any considerable portion of the body, and continued more than a very brief time, produces headache, dullness, sometimes nausea and vomiting, loss of sensibility, and other unpleasant and painful symptoms. It is thus seen that the effects of cold are quite different — exactly opposite, in fact — as the application is a prolonged or a brief one. The long application produces effects in some degree permanently sedative, while the brief application is followed by a momentary condition which may be termed shock, and which is usually followed ver}7 quickly by a reaction analogous to stimulation when produced in any other manner. Effect of Cold upon tlie Pulse. — The experiments of Drs. Currie, Bell, and others, show conclusively that the cold bath has the uniform effect of diminishing the frequency of the heart’s action from ten to twenty beats in a minute below the usual standard. Upon the first ap¬ plication of cold, there is a slight increase in the rate of pulsation ; but this soon subsides, and is succeeded by a marked diminution. The ulti¬ mate effect is the same, whether the application is made at its maximum degree of severity or not; but if the application is first warm, being gradually reduced in temperature, the result is reached without the oc¬ currence of the unpleasant shock, or feeling of chilliness, which attends the sudden application of cold, especially in persons of delicate nervous sensibilities. The amount and after-duration of the diminished rate of pulsation depends upon the temperature and duration of the bath. In health, it does not commonly extend beyond a few hours at most. Effect of Cold upon Temperature. — It was also shown by the same experimenters that the temperature of the body is reduced pro¬ portionately with the action of the heart. The natural temperature, as shown by a thermometer placed in the axilla, is 98° F. During and after a cold bath, the thermometer applied to the same part, indicates from one-half a degree to five or six, or even more degrees, diminution of temperature. In some cases the temperature continues to fall after EFFECTS OF COLD BATH. 605 the bath. The real temperature is lessened, even though the skin may glow, and even seem to possess increased warmth. Cold and heat are, within certain limits, wholly relative terms to the nerves of sensibility. What is warm at one time may be cold at another, though the temper¬ ature remains the same. The same temperature may be warm to one hand and cool to the other. Temperature can only be accurately de¬ termined by the thermometer. Rationale of Effects of the Cold Bath. — The manner in which the cold bath produces the sedative effects noted, is apparently simple. \\ hen applied locally, to a single organ or part, it diminishes the cir¬ culation in the part by occasioning contraction of the muscular coats of the arterioles, or small arteries. Their caliber being thus lessened, they of course allow the passage of less blood, and the circulation in the part is diminished. There are three causes for the decrease of heat ; viz., — 1. A portion of the heat of any part is brought to it by the blood ; the supply of blood being lessened, the heat is diminished. 2. Heat is produced by vital changes which occur in the capilla¬ ries 'or their immediate vicinity. These depend chiefly upon the sup¬ ply of oxygen, which, again, is largely regulated by the blood supply ; and it being lessened with the blood, the amount of heat ■produced is diminished. Again, it has long been known that all the vital activities of the body, which result in its growth, repair, and development, as well as all the functions peculiar to animal life, including animal heat, are due to the action of the protoplasmic elements of the body. It has also been long known that cold will restrain these activities. Every microscopist is familiar with the fact that in studying the movements of white blood corpuscles, or of other protoplasmic elements, it is neces¬ sary to maintain a temperature at least equal to that of the body. When the temperature falls, the amoeboid movements cease ; as the temperature is raised, they begin again. If the temperature is raised above that of the body, there is a wonderful and unnatural increase in the activity of the protoplasmic masses. In view of these well-known facts, are we not justified in the conclusion that the application of cold to the body, either locally or generally, may lessen the production of heat by lessening the vital activities, or protoplasmic movements by which animal heat is largely, if not wholly, maintained ? It may be suggested in answer to this argument, that animal heat may be pro- 606 RATIONAL REMEDIES FOR DISEASE. duced by chemical changes within the body analogous to combustion. To this we may rejoin that while the renowned Dr. Priestly, originally, and afterward Dr. Currie, and still later, the great chemist of Ger¬ many, Prof. Liebig, attributed the production of animal heat to the union of oxygen with hydrogen and carbon within the body, by a proc¬ ess of real combustion, later investigators have unanimously dis¬ carded the idea as unsupported by facts. The present view on this subject is that oxygen does not combine directly with the carbon, hy¬ drogen, or any other of the elements of the tissues or of the blood, but that it is assimilated like other forms of food, while carbon di-oxide is excreted, like urea, cholesterine, and others of the effete matters of the body. Animal heat is one of the results of the various metamorphoses of the tissues by which these waste matters are produced. 3. The water in contact with the part, being of a lower tempera¬ ture, abstracts heat from it as it would from any other body of a higher temperature than itself. When the application of cold water is more general, being made to the whole body or to a considerable portion of it, the same .effects are produced on a larger scale. A large proportion of the small arteries of the body, being brought under the influence of cold, are made to contract, thus directly lessening the circulation, and so diminishing, also, the production of heat. Through the sympathetic system, the same effect produced upon the small arteries is produced also upon the heart, lessening the rapidity of its contractions. Again, it has been satisfactorily shown that the action of the heart is largely controlled by the action of the small arteries; so that we have abundant expla¬ nation of the decrease in the rate of pulsation. Finally we have a cold fluid in contact with a large portion of the body, abstracting heat by conduction, as Veil as lessening its production. The rationale of the effects of a cold bath of very short duration is equally simple. The sudden impression of cold excites to vigorous action the nerve centers which have control of the circulatory and heat-producing functions, and thus, through the vital reaction of the system, effects contrary to those of a prolonged application are ob¬ tained. Thus we see that water may be applied in such a manner as to produce either most powerful stimulating effects, or to depress the vital activities of the body, diminishing circulation and animal heat in a most remarkable manner. THE EOT BATH. 607 The effects of local applications of cold water are less marked upon the general system, though essentially the same effects are observed in the stimulation of the circulation and vital activities by short and the opposite by prolonged applications. The pulse and general tempera¬ ture of the body are affected in proportion to the extent of the appli¬ cation. The Hot Bath. — We shall include under this head applications of a temperature above 98° F., the mean temperature of the body. As with the cold bath, the effects differ greatly, according as the applica¬ tion is brief or prolonged. Local and general applications also differ in their effects. A brief local application causes an increase in the circulation of a part which very closely resembles, perhaps is identical with, active congestion. The small artei’ies are distended, and the vital activities and heat of the part are increased. The several effects seem to be lit¬ tle different from those resulting from the application of a mild sin¬ apism. The action of the vital instincts is defensive in both cases. When applied to special organs, special effects are produced. For instance, a hot fomentation applied to the head for a few minutes will usually produce drowsiness by diversion of a portion of the blood sup¬ ply of the brain to the skull and scalp. Prolonged applications pro¬ duce a more or less permanent relaxation of the blood-vessels, and con¬ sequent congestion. A hot bath applied to the whole body, or a large portion of it, pro¬ duces an acceleration of the pulse and an increase of animal heat pro¬ portionate to the temperature of the bath. A bath at 106° to 108° F. will increase the pulse from the normal standard to one hundred or one hundred and twenty beats in a minute, in a short time. A bath four or five degrees hotter has been known to increase the pulse to more than one hundred and fifty beats in a minute. When a hot bath is prolonged, the face becomes flushed, and the whole skin very red ; the head aches ; sight is sometimes dimmed ; ringing in the ears, faintness, a stinging pain in the skin, and intense desire to urinate, are symptoms which are often present. Copious perspiration and intense congestion of the skin are constant effects. The cutaneous congestion, from relaxation of the blood-vessels, is apt to continue to exist after the bath, if it is greatly prolonged, to the se¬ rious injury of the subject. The effects of the vapor bath are essentially the same as those de- 608 RATIONAL REMEDIES FOR DISEASE. scribed, though a somewhat higher degree of heat is tolerated without injury. In the hot-air bath a still higher heat is borne with impu¬ nity. When local applications are made at a temperature of 108° to 120° F., the first effect seems to be contraction of the small vessels. At any rate, such an application is the best known means of checking capillary hemorrhage. Rationale of Effects of the Hot Bath. — It scarcely need be repeated that all of the effects noticed, as well as those of all other baths, are chiefly the results of modifications of vital action occasioned by the agent employed. The application of heat to the body occasions relax¬ ation of the muscular coats of the small arteries, and increased action of those vessels. No doubt this is for the purpose of bringing moist¬ ure to the surface to protect the tissues against the unnatural heat. As is the case with cold baths, the causes which modify the heat are three; viz., — 1. The increased quantity of blood circulating through the part brings to it an increased amount of heat. 2. Increased vital and chemical action increases the production of heat. 3. The body absorbs heat from the surrounding medium as any other colder object would do. In the general application of hot water or vapor, effects similar to its local effects are produced upon the whole surface of the body, in¬ volving, also, to a considerable extent, the deeper structures. The pulse is accelerated because the small arteries are distended and more active, creating a demand for a greater quantity of blood, requiring an increase in the heart’s action. It is also quite probable that the action of the heart is somewhat quickened as the result of the influence of heat upon the pneumogastric nerve which controls it. The cerebral symptoms, faintness, etc., which occur when heat is applied in excess, are the result of the diversion of so large a propor¬ tion of the blood into the superficial vessels. A prolonged hot foot bath or leg bath will often produce faintness. There are few agents which will so rapidly produce such powerfully excitant and stimulant effects as the hot bath. The painful and unde¬ sirable results occasioned by its incautious use are evidences of its power. The Harm Bath. — In this connection we apply the term warm to THE WARM BATH. 009 baths of a temperature between 85° and 98° F., though baths of a temperature between 85° and 92° would be more accurately termed tepid, which term is applied to baths of that temperature elsewhere than in this immediate connection. The warm bath never exceeds the temperature of the body, and is usually below it. Its effect is uniformly to diminish the frequency of the pulse and of respiration, and to decrease animal heat. Its effects are the same, though less in degree, as those of the cool or cold bath, in this respect, but they differ in sevei’al other particulars. Unlike the cold bath, the warm bath is not accompanied by an unpleasant shock, or chill, and hence is not followed by reaction. It promotes the action of the skin in a very marked degree, increasing both per¬ spiration and absorption. When continued for an hour or two, the weight is appreciably increased by the absorption of water. Its gen¬ eral effects are very mild and soothing, often inclining the patient to sleep. This bath seems to produce its effects not so much by exciting the vital energies to abnormal action or resistance as by supplying the most favorable conditions for the performance of the natural and usual functions. This is doubtless on account of its close approximation to the temperature of the body. In this respect, if this supposition be true, it differs from baths of a temperature either much above or greatly below the normal temperature of the body. Hebra, the eminent dematologist of Vienna, has shown by actual tests that human beings may exist in the warm bath not only many hours, but days, weeks, and even months — in one case nine months — without suffering the slightest inconvenience, all the bodily func¬ tions being performed without the least departure from the normal standard. The warm vapor bath produces effects quite analogous to those of the warm water bath. Its effect upon the processes of perspiration and absorption is a little more marked, even with the same degree of temperature. The results differ somewhat, according as the whole body is enveloped, so that the warm vapor is taken into the lungs, or the head excluded. A more equable effect is produced by including the whole body in the bath, and no harm can result if the temperature is not raised above that of the body, as it should not be, in the warm bath. 39 G10 RATIONAL REMEDIES FOR DISEASE. Sympathetic Effects . — There is scarcely room for doubt that many of the effects of the various kinds of water applications are wholly of a sympathetic character. All portions of the body are inti¬ mately associated together by a system of nerves called the sympa¬ thetic system, from their peculiar function. Certain portions, as the skin and mucous membrane, are particularly related. The large num¬ ber cf sensitive nerves which connect the skin with the brain, bring it in peculiarly close relations to that organ, and give additional potency to any agent applied to so extensive a surface. The well-known fact that burns of the skin are often the occasion of fatal ulceration of the mucous membrane of the intestines sufficiently attests the intimate re¬ lation between these two tissues ; while the effects upon the skin of mental emotions, as of shame and of fear, are conclusive evidence of the peculiar closeness of relation between the cerebral and cutaneous organs. Another fact observed by physiologists clearly shows the sympathetic effects of water under some circumstances, at least. It has been noticed that if one foot be placed in cold water, the other foot becomes warmer, an effect undoubtedly due to the sympathy ex¬ isting between the two organs, both being alike affected by the effort of the system to maintain the normal temperature of the exposed or^an. O Dr. Chapman, of London, a few years ago called the attention of the profession to the fact which he claims to have demonstrated that the application of heat or cold to the spine produces opposite effects in the parts to which they are applied and the parts of the body to which the nerves originating in those parts are di .tributed. That is, cold to the spine causes an increase in the blood supply of remote parts, while heat produces opposite effects. This he explains by the supposition that cold paralyzes the vasomoter centers and that heat stimulates their action. We have verified many of his results in our own prac¬ tice, and believe the effects to be such as he claims. Modes of Administration. — There are numerous modes of ad¬ ministering baths of all temperatures, each of which produces some modification of the general effect of the given temperature. For ex¬ ample, such baths as the douche, the spray, and the shower bath, are much more cooling in their effects than a full bath at the same tem¬ perature ; since, in the latter case, nearly the whole body would be submerged in a medium of equable temperature, while in the case of the spray, etc., the body would be additionally cooled by the rapid REMEDIAL PROPERTIES OF WATER, (jj | evaporation taking place upon its surface. Packings of all sorts pro¬ duce powerful diaphoresis, or perspiration. Alternate hot and cold applications occasion strong stimulant or revulsive effects. Many other peculiar effects are obtained by particular modes of administra¬ tion, which will be described hi their proper place. REMEDIAL PROPERTIES OF WATER, OR HYDRO¬ THERAPEUTICS, Under this head we shall consider, briefly, the different remedial purposes to which water may be applied, endeavoring to explain its various medical uses by its physiological effects, which we have al¬ ready studied. The value of most remedies is usually estimated by the number of “properties” which they possess and the efficiency and certainty with which their various effects may be obtained. Considered in this light, water may be presented as one of the most useful of all known reme¬ dies. Indeed, when the great diversity of its uses and the prompt and efficient character of its effects, together with the kindly manner in which it is received by the system, are considered, it is not to be wondered at that it has found not a few enthusiastic advocates who have believed it to be a universal remedy, a panacea for all human ills. Those who are best acquainted with its properties and its potency when properly applied are the most enthusiastic in its praise. The eminent Dr. Fothergill, of England, well known in this country through his admirable papers in American medical journals, would seem to be almost as warm an advocate of its use as the most ardent disciple of Priessnitz. In his “Hand-Book of Treatment” he says, “ Personally I believe that hydropathy, rescued from quackery and under proper professional guidance and superintendence, will form one of the most universal remedies of the future.” The same author again remarks in the work referred to, “ Indeed, in hydropathy we see empirically achieved what a scientific physiology would ere long- have indicated as the logical and rational plan of treatment of numer¬ ous affections of mature and advanced life, which take their origin in the imperfect elimination of waste, either the products of tissue change, histolysis, or the results of proteine compounds imperfectly as¬ similated or furnished to the system in excess of its needs.” Percy, an eminent foreign physician, surgeon-in-chief of the armies 612 RATIONAL REMEDIES FOR DISEASE. of the Moselle and the Rhine, declared that he would abandon the prac¬ tice of medicine if water were denied him as a remedial agent, saying, “ Water furnishes immense resources as a curative agent.” The remedial or therapeutic properties of water at various tempera¬ tures and applied in various forms may be stated to be the following : — Refrigerant or antiphlogistic, tonic, sedative, antispasmodic, ano¬ dyne, anesthetic, styptic, dissolvent, eliminative, laxative, emetic, de¬ rivative, and alterative. Others might be added, but these are sufficient to represent its several uses. Water as a Refrigerant. — Refrigerant, antiphlogistic, or antipy¬ retic remedies are such as have the effect to diminish bodily heat and re¬ strain inflammation. These remedies are very useful, indeed indispensa¬ ble, in the rational treatment of fevers and local inflammations, as well as in the prevention of inflammation from contusions, lacerations, fract¬ ures, and other surgical inj uries. When applied at a temperature less than that of the body, water lessens the production of heat, and also ab¬ stracts it by conduction. For this purpose it is unrivaled in the whole range of remedial agents. No other remedy will so readily, so easily, and so certainly, bring down the temperature of a fever, diminish the pulse, and ameliorate all the symptoms depending on exaggeration of vital activity as this. How this is effected has been previously ex¬ plained in considering the physiological effects of water. Water as a Tonic. — Water may be used in such a way as to in¬ crease the rapidity of the circulation and the temperature very quickly and powerfully. The hot bath is a most efficient stimulant, in the true sense of the word. It will so excite the circulation as to increase the pulse from seventy to one hundred and fifty in fifteen minutes. The tonic effects of a short cool bath are well appreciated by all who have ever enjoyed it. Sedative Effects of Water. — Remedies which depress vital action are termed sedatives. Cold water is one of the most effective sedatives. It will lower the temperature, rapidly diminish the pulse, and restrain excessive vital action to almost any degree desired, and without any of the unpleasant after-effects and few of the immediate dangers which ac¬ company the use of such remedies as prussic acid, tobacco, and blood¬ letting. The cool or tepid bath will often reduce the pulse twenty to forty beats per minute in a short time. Antispasmodic. — No remedy is so certainly successful in hysterical convulsions as water. In infantile convulsions, its success is also unri- REMEDIAL PROPERTIES OF WATER. 613 valed. In cramp, tetanus, and various forms of spasmodic affections, and even in puerperal convulsions, its utility has been well demonstrated. W ater as an Anodyne. — The effects of local applications of both warm and cold water in relieving pain are well known. In many other modes of application it is also effective in a very high degree in relieving pain and nervous irritability. Water as an Anesthetic. — The anesthetic effects of water at a very low temperature or in the form of ice are too well known to need more than mention. Styptic Effects of W ater. — The efficiency of cold water as a ready means for arresting hemorrhage has long been recognized in surgery ; within a few years, however, it has been discovered that hot water, when properly applied, has a still more powerful effect, especially in cases of capillary oozing or bleeding from small vessels. We have on several oc¬ casions checked almost instantly a bleeding which resisted all other means which could be applied. Water as a Dissolvent. — The power of water to secure the ab¬ sorption or dispersion of some forms of morbid growths, particularly glandular enlargements, is now well recognized. By cold, or alternate hot and cold, applications, chronic swellings of the joints and other parts, serous accumulations, enlargements of lymphatic glands, of the thyroid gland, and even of the spleen and liver, may be successfully treated. Eliminative Effects of Water. — As water is a perfect solvent for the various excrementitious substances produced in the body through tissue waste, as well as of all the foreign elements which find entrance to the blood, it is of all substances the most efficient and powerful elim¬ inative. It has been proven to be thus eminently useful as a diaphoretic, in increasing the action of the skin ; as a diuretic, in facilitating excre¬ tion by the kidneys ; and as a most excellent cholagogue, in increasing the activity of the liver and occasioning a consequent increase in the production of bile. It is also, when properly applied, an excellent ex¬ pectorant, and undoubtedly also increases the action of all the excretory organs of the bodv. Laxative. — Used in various ways, water is very effectual in produ¬ cing: movement of the bowels, but never occasions those violent and un- pleasant symptoms which accompany and succeed the use of purgatives. Emetic. — In the great majority of cases no other emetic is needed, and no better can be found. Nearly all emetics require water to render them efficient. 614 RATIONAL REMEDIES FOR DISEASE. Alterative. — For a long period, mercury has been considered as the champion alterative of the materia medica. It must yield the place to water, however ; for the most it can do is to destroy the elements of the blood, while water not only accelerates waste, but increases construction in the same proportion, according to the experiments of Prof. Liebig and other eminent observers. This e fleet of water results from both its in¬ ternal and its external use. Derivative, — One of the most important properties of water applica¬ tions is their powerful derivative effect. No other application, internal or external, can equal them in efficiency and certainty of action. There are very few agents which possess so many remedial properties as water. There are none which effect so much with so little expense to the vital powers of the patient. Many drugs will produce results similar to those obtained by the use of water, and thus accomplish good, no doubt ; but at the same time they often work so much mischief in the system that the evil done is frequently much greater than the good ac¬ complished. The aim of the faithful physician should be to accomplish for his patient the greatest amount of good at the least expense of vital¬ ity ; and it is an indisputable fact that in a large number of cases water is just the agent with which this desirable end can be obtained. HISTORY OF HYDRO-THERAPEUTICS, The utility of water as an agent in the treatment of disease is not a modern discovery, as the pretensions of some aspirants for notoriety have led many to believe. A very cursory glance at the history of various ancient nations furnishes sufficient evidence that the use of the bath as a curative agent was of very remote origin. The works of the oldest medical authors contain numerous references to the bath, recommenda¬ tions of its use in cases of disease, and testimonials of its good effects when properly employed. As this is a matter of some interest to many of those who employ and advocate the use of water as a remedial agent, as well as to those who are investigating its merits, we shall devote a little space to a sketch of the use and estimation of the bath by various nations and tribes — civilized and barbarous — and regular and irregular physicians, from the remote ages of antiquity down to modern times. The Bath in Egypt .—That bathing was practiced to a considerable extent by the Egyptians at a very early period, is evinced by both sacred and profane history. It was through obedience to this custom that GREEK AND ROMAN RATES. G15 Moses was discovered among the rushes by Pharaoh’s daughter as she went down to the river-side to bathe. Pictures discovered in ancient. Egyptian tombs represent persons preparing for the bath. We have no expression of the estimate which was placed upon the bath as a remedial agent ; but it is hardly possible to believe that an agent held in such high esteem as a preventive of disease should not be valued as a useful remedy. Bathing among the Jews. — The code of laws prepared by Moses, under divine instruction, for the government of the Hebrew nation after its departure from Egypt, made bathing a prominent feature. The con¬ nection of the bath with the treatment of leprosy would naturally lead to the conclusion that it was employed for its curative effects. Pe rsian Baths. — The ancient Persians held the bath in such hicdi © esteem that they erected magnificent public structures devoted to bathing. The baths of Darius are spoken of as especially remarkable. According to the statements of a German physician, the Persians still continue the use of water as a remedial agent, especially in cholera times, when pails of water are in some cities placed at the street cor¬ ners and along the road to be in readiness for use as soon as an indi- vidual is attacked. The mode of treatment is the cold douche, fol¬ lowed by vigorous friction of the skin. The Batli among the Greeks. — The cold bath was employed among the Greeks. Lycurgus, the famous Spartan legislator, pre¬ scribed its daily use by all his subjects, not excepting the tenderest infants. In later times, the warm bath was introduced, and stately buildings were erected for the accommodation of bathers. © The learned Greek, Hippocrates, the father of medical literature, and a very acute observer of disease and the effects of various agents upon the body, highly recommended the use of water in many dis¬ eases, describing with great care the proper mode of administering a simple bath. He laid great stress upon the careful and skillful use of the bath, asserting that, when improperly applied, it, “ instead of doing- good, may rather prove injurious.” His directions for the employ¬ ment of the bath were very discreet. He very wisely remarks that those patients whose symptoms are such that they would he benefited by bathing should be bathed, even though some of the requisite conven¬ iences may be wanting ; while those whose symptoms do not indicate the need of this remedy, should not employ it, though all the neces- 616 RATIONAL REMEDIES FOR DISEASE. sary appliances are at hand. He made great use of water as a bever¬ age in treating disease. © © Roman Baths. — The Romans excelled all other nations in the sumptuousness of their bathing arrangements. Their public baths were among their greatest works of architecture, and were supplied with every convenience for increasing the utility and luxury of the bath. Kings and emperors vied with each other in perfecting and en¬ larging these sanitary institutions. Accommodations were provided, in some cases, for nearly 20,000 persons to bathe simultaneously ; and at one time the number of public baths in Rome was nearly one thou¬ sand. Even Nero, whose name has come down to us covered with in¬ famy, has the credit of doing at least one good act in erecting a mag¬ nificent public bath, though even the detergent effects of such an act can hardly cleanse his character of the many foul blots by which it is rendered odious. Celsus and Galen, two noted Latin physicians, extolled the bath as an invaluable remedy almost two thousand years ago. The latter pronounced the bath to be one of the essential features of a system of perfect cure which he termed opotheraphia, exercise and friction being the other essentials. If the regular physicians of half a century ago had followed the practice of Galen, as described in his works, they would have refreshed their languishing fever patients with cold water as a beverage instead of leaving them to be consumed by the pent-up fires which parched their lips, disorganized their blood, and finally ended their sufferings with their lives. Celsus was proud to boast of employing the bath more frequently and systematically than others had done before his time. The emperor Augustus was cured by the bath, of a disease which had baffled all other remedies. Testimony of Arabian Physicians. — Although the Arabians are at the present day looked upon, and justly, as a horde of wandering wild-men, a thousand years ago their physicians were among the most learned of the age; and they were as sensible as learned, we judge, for they were most enthusiastic advocates of the efficiency of the bath. Rhazes, one of the most eminent of them, describes a plan of treating small-pox and measles which would scarcely be modified by the most zealous advocate of water treatment at the present day. Avicenna and Meshnes, with others, may be mentioned as holding similar views. MODERN BATHING CUSTOMS. 617 The bath was much used in pestilences by this nation, and was largely employed in Constantinople in the fifteenth century. Modern Bathing Customs. — Three centuries ago, public vapor baths were very numerous in Paris, being connected with barber shops, as are many baths in this country at the present time. Accord¬ ing to Dr. Bell, Paris can still boast of a great number of bathing es¬ tablishments. He states that in the baths connected with the city hospitals nearly 180.000 baths were administered in a single year to out-door patients. Doubtless those treated in the hospitals -were duly washed and steamed as well. This is certainly a very marked con¬ trast with what we see in the hospitals in this country at the present day. Notwithstanding the advances in many other particulars of hospital management, the cuticles of patients are sadly neglected. In some of our largest hospitals, the filthiness of many patients is so great that close proximity to them is absolutely intolerable. Half a dozen of them, placed in a warm room, speedily impart to the air a fetor un¬ equaled by anything but the effluvia arising from a neglected pig-sty. Such neglect is inexcusable. C' The Germans of olden time were very fond of bathing, according to their historical records, and during the Middle Ages, when plagued with the leprosy, the national faith in the virtues of the bath was man¬ ifested by making it a religious duty. It is related of Charlemagne that he used to hold his court in a huge warm bath. Modern Teutons seem less partial to the bath, having transferred their fondness from aqua pura to lager-beer. Although the bath was very freely used in England while the island was occupied by the Romans, who erected commodious baths like those in Rome, the wholesome practice is now sadly neglected by the English people, if wre may credit their own writers. It is a curious fact that the bath seems to be quite generally neg¬ lected by the most civilized races, while it is almost universally em¬ ployed by those less advanced nations, the Russians, Turks, Finland¬ ers, and the inhabitants of Persia, Egypt, Barbary, and Hindostan. The Finlanders make great use of the sweating bath. To nearly ev¬ ery house is attached a small sweat-house, where they subject them¬ selves to a temperature of more than 160 F., often emerging at once into an atmosphere much below freezing, with apparent impunity. The Turkish and Russian baths, similar to which are those in use in Egypt and India, are elsewhere described. G18 RATIONAL REMEDIES FOR DISEASE. The North American Indians employ the bath for many diseases. They have original and peculiar ways of administering both water and vapor baths. The most common bath among them is the vapor, followed by a plunge into a neighboring stream. They generate the steam by pouring water upon hot stones while they are inclosed in a small, close hut, made of mud or skins. The native Mexicans secure a hot-air bath by confining themselves in a brick sweat-house which is heated by a furnace outside. These savages seem to have the most implicit confidence in the efficacy of the bath, always employing it when ill, and with excellent success. The Africans, also, are not un¬ acquainted with the medical uses of the bath. It is stated that on the outbreak of small-pox on a slave-ship many years ago the negroes begged so piteously when treated in the usual manner, by smoth¬ ering: beneath many thicknesses of blankets and mattresses, to be allowed to follow their own method that they were at last permit¬ ted to do so, when they at once tied ropes about the bodies of the patients and let them down into the sea. This was done several times a day ; and all thus treated recovered. Modern Medical Use of Water.- — In the early part of the eight¬ eenth century, a Sicilian named Fra Bernado acquired the title of “ cold-watei doctor ” from his exclusive use of coll water in treating the sick. At the very beginning of the eighteenth century, Floyer published a history of bathing which contains accounts of many remarkable cures effected by means of the bath, which he recommended as a most efficient- cure for numerous diseases. A Mr Hancock, a clergyman, published in 1722 a tract entitled, “ Common Water the Best Cure of Fevers.” Another writer, in a work entitled “The Curiosities of Common Water,” published in 1723, speaks of water as an “excellent remedy which will perform cures with very little trouble, and without any charge,” and “ may be truly styled, a universal remedy.” Both French and German writers were zealously advocating the use of water as a remedy for many diseases at this same period. Many of the French surgeons had also discovered the immense utility of water in surgery, receiving their first lessons of instruction from an ignorant and superstitious miller, who used water in conjunc¬ tion with charms. In the latter part of the last century, Drs. Jackson and Currie each published reports of cases of fever in which they had found the use of MODERN MEDICAL USE OF WATER. 610 the bath a remedy of remarkable efficacy. Dr. Currie obtained many followers for a time, but no very deep impression was made upon the public mind, though his cases were authentic, and were very ably re¬ ported. About the end of the first quarter of the present century, a native of Grsefenberg, a small town in Austrian Silesia, by the name of Priess- nitz, met with an accident by which three of his ribs were broken. He treated himself by applications of cold water, and then tried the same remedy upon others in similar cases. His success encouraged him to make further experiments, and though an ignorant peasant, his natural acuteness enabled him to devise various means for applying water to the body, and to suit the application to different diseases. His increasing- success attracted numerous patients, and his fame became, in a few years, world- wide. Many of his methods were very rude, and his igno¬ rance of medical science often led him into errors; but he succeeded in restoring to health hundreds of patients whose maladies had been pro¬ nounced incurable. The interest in the new method became so great that numerous other individuals, equally ignorant and possessing less shrewdness, under¬ took to imitate the German innovator. Some of them were successful, many of them were not; all were alike in committing numerous blun¬ ders through ignorance of scientific medicine. But public attention was called to the utility of water as a remedial agent so forcibly that a powerful impression was produced in its favor. From that time until the present, the use of water has been largely in the hands of unscien¬ tific empirics who have advocated it as a specific, and employed it to the exclusion of other remedies in a large measure. This course, together with many other gross errors connected with the practice, has deterred scientific physicians from employing it sufficiently to test its merits, only in a few exceptional instances. The friends of Priessnitz claimed for him a great discovery; but as we have seen, he discovered nothing which was not known a century before, if not, indeed, some thousands of years previous. It was doing Priessnitz no injustice to say that he did little or nothing toward estab¬ lishing principles, but followed, chiefly, a routine method of practice. Testimony of Eminent Physicians. — A few scientific members of the medical profession have investigated the subject in some degree, however, at various times, and the result has been that at the present day the utility of water is a well-recognized fact, and it is now often G20 RATIONAL REMEDIES FOR DISEASE. prescribed in the standard text-books as an excellent remedy for many diseased conditions. Yet, that there is still a want of appreciation of the remedy is fully attested by the infrequency of its use by the regular profession. This neglect may be due in part to a prejudice which the members of the regular profession have acquired on account of the quackery which has too often been connected with the use of this rem¬ edy. Nevertheless, there is no good reason why an efficient remedial agent should be suffered to receive the stigma which properly attaches only to those who are responsible for its abuse. Within the last few years there has been a growing interest in hydrotherapy, especially among the leading physicians of France and Germany. In this country, also, an interest has been awakened in the subject, al¬ though among the non-progressive part of the medical profession there still remains much of the “ old-time” prejudice, which has for years pre¬ vented this powerful remedial agent from taking its proper place in the front rank of therapeutic agents. Perhaps it may be interesting to con¬ sider the testimony of a few distinguished medical authorities in favor of water as a remedial aeent. O In favor of the use of water in febrile diseases we may cite the well- known names of Brand, Hagenbach, Zieinssen, Winternitz, Immerman, M osier, Wilson, Fox, Bartels, Liebermeister, Ludwig, Schroeder, Fiedler, Hartenstein, Weber, Greenhow, Thompson, Niemeyer, and Ringer, among foreign physicians of eminence; and a still larger list of physi¬ cians of the highest standing in this country might be added. A few years ago we were present at a meeting of the New York Academy of Medicine, where we had the pleasure of listening to an able paper by Prof. Austin Flint, M. I)., president of the Academy, entitled, “ The Researches of Currie, and Recent Views concerning the Use of Cold Water.” The following is a brief abstract of the paper: — • Currie employed scientific methods in observing the phenomena of disease. He was one of the first to employ the thermometer in studying disease, and his observations can be received as reliable. The use of water externally as a means of reducing the temperature of the body in disease has recently been coming quite prominently into notice. According to Liebermeister, a noted German medical author, Currie was the first to systematize the use of water. His work was published in 1797. Liebermeister, in his recent article on typhoid fever, accords to cold water the first place in importance as an article for re¬ ducing the temperature. The use of water for this purpose is at present EMINENT TESTIMON Y. 621 attracting much attention; and it is safe to predict that it will soon oc¬ cupy an important place as a remedial agent. Much harm has been done by the “ rude empiricism ” of Priessnitz, and the various water-cures in the country; though much good has also been accomplished by the latter institutions, and they have in a measure prepared the public mind for the general introduction of water as a remedial agent. After the publication of the views of Currie in 1707, his method of practice, which was chiefly hydropathic, became quite general, but it was soon nearly forgotten. Trousseau recommended water treat¬ ment in scarlatina, and the use of the remedy has continued to be rec¬ ommended in the text-books ; but as a measure of treatment in prac¬ tice it has become nearly obsolete. It is, however, obvious that unless we accept the absurd proposition that diseases have changed since Currie’s time, the remedy which he recommended so highly must be just as efficient now as then. Dr. Currie made use of the cold douche in fevers, applying it vig¬ orously to the patient while in the height of the fever, and continuing it until the temperature became decreased, as indicated by the ther¬ mometer and the pulse. He treated seven cases of continued fever by this method at the Liverpool infirmary. All recovered. In an epi¬ demic of typhoid fever among a regiment of troops, he treated fifty- eight cases, using the cool tepid douche in all but two cases. The lat¬ ter died. The remaining fifty-six recovered, the disease being greatly shortened in more than half the cases. Dr. Currie asserted that in small-pox, the use of the bath afforded instant relief to the patient, and caused the disease to assume a benig¬ nant form. He found the cold bath always effectual in tetanus and convulsions, as also in hysteria. In temporary insanity from the use of liquor, this acute observer found that the cold plunge was the most efficient remedy for the worst cases. But Dr. Currie’s practice was not confined to cold water. He ob¬ served that affusion with tepid water was not only a more pleasant application, but that it was even more effectual in reducing unnatural heat than cold water, as it produced no reaction, not being at all stim¬ ulating in character. With regard to the efficacy of this agent, Dr Currie stated that by 622 RATIONAL REMEDIES FOR DISEASE. its use in fevers the pulse would be reduced thirty or forty beats, with a corresponding decrease of temperature and almost immediate re¬ lief of headache. In his second volume, published some six years after his first vol¬ ume, Dr. Currie declared that although his experience in the use of water, especially in fevers, had been very extensive, he had had only four fatal cases in which water was employed, and had never met with a single evidence of its being in the least degree objectionable or injurious. Neither had he found that it had been thought to be ob¬ jectionable by those whom he had treated. He details a very inter¬ esting account of his treatment of scarlatina in the cases of his two sons, aged, respectively, three and five years. He gave the older, in thirty-two hours, fourteen affusions, varying from cold to tepid. Twelve were found to be sufficient for the younger one. Both became convalescent in three days. It was established by Currie that by the use of water the course of typhoid fever may be abbreviated. This is not even claimed for the modern remedies in common use. In referring to his own exoerience in the use of water, Dr. Flint re* marked, “ The relation of my own experience will of necessity be stated in a few words, as my employment of the remedy has hereto¬ fore been much more limited than it will be in the future if my life is spared.” He then related some ver}^ interesting cases in which he had employed water as the chief remedy with the most excellent success. He also took occasion to recommend, as one of the best means of ap¬ plying water in fevers, the wet-sheet pack as employed in the various hydropathic institutions of the country. He had used the continued cold pack in a number of the worst cases of sun-stroke in Bellevue Hospital with marked success. This remedy is still employed there in this class of cases. In a case of obstinate remittent fever, which was not in the least ben¬ efited by the thorough use of quinia, he employed the cool pack thirty- five times in a week, continuing each application from ten to thirty minutes, and always with great relief to the patient, although he finally died. He expressed the opinion that if he had employed the pack more thoroughly, making the applications longer and more fre¬ quent, the patient might have recovered. Currie announced a true theory when he said that the voice of nat¬ ure should not he superseded by theories. He advocated the free use EMINENT TESTIMONY. 623 of water as a beverage in febrile diseases as an important remedial agent. Dr. F. unhesitatingly advanced the belief that the chief ben¬ efit derived from the numerous mineral waters so largely used was only that which was due to the properties of pure water. He stated as proof, that it was not long since demonstrated by chemical analysis that the only thing peculiar about the water of a certain spring, fa¬ mous for medicinal virtues, was its remarkable purity. He also sug¬ gested the introduction of distilled water for cooking and drinking purposes as a necessary sanitary measure. Dr. F. then related a remarkable case of acute inflammation of the kidneys in which the patient exhibited the characteristic symptoms of poisoning from the retention of urea. After other remedies were tried in vain, the patient’s life was saved by the simple administration of water as a beverage at short intervals. The diuretic effects of the water soon washed away the poison and gave immediate relief. After the conclusion of the paper, by Dr. Flint, the venerable Dr. Richards arose and gave his experience in the use of water. His ideas of hydropathy were obtained when he was a young man, from Dr. Currie’s works. He adopted the practice of Dr. C. at that time in an epidemic of typhoid fever, and with such remarkable success as to astonish old practitioners. He stated that he had cured more than one hundred cases of obstinate constipation by simply directing the pa¬ tient to drink a glass of cold water half an hour before breakfast, each morning. In one of these cases the patient had not had a natural pas¬ sage from the bowels for a number of years ; but he was effectually cured, by the simple remedy mentioned, in the course of a few months. Dr. Lovle gave an interesting resume of ten years’ experience in the use of water, with uniform success, especially in convulsions and scarlatina. He had employed water alone in about one hundred cases of acute inflammation of the kidneys and dropsy after scarlatina, and with wonderful success in every case. He had found it equally suc¬ cessful in coma, restoring consciousness when life was apparently ex¬ tinct. During the late war, he on one occasion renovated twenty am¬ bulance loads of exhausted soldiers who had fallen on the march, by the judicious use of water. He recommended water most highly as an excellent diuretic, and a capital regulator of the bowels, far superior to “ after-dinner pills.” He commended it also as an efficient remedy for sun-stroke and frozen feet. The sentiment of the audience — which was wholly composed of G24 RATIONAL REMEDIES FOR DISEASE. medical gentlemen — was shown by the hearty applause with which the remarks of each speaker were received. We might add much other medical testimony, but as we could give no higher authority than the distinguished Dr. Flint, who stands at the head of medical practice in America, being author of the standard American text-hook on practical medicine, we will not weary the reader with further quotations. The German physicians, as well as German medical works, abound with tributes to the value of water. American medical journals are full of accounts of the beneficial results following its use in fevers and numerous other conditions. In surgery, the employment of water is rapidly gaining entire precedence. It has replaced nearly all other kinds of dressing for wounds, and its use has saved a valuable limb to many a poor sufferer who must otherwise have submitted to amputation. In short, wherever it is faithfully and intelligently applied, water is working wonders. Yet it is still little used in comparison with its importance. Especially is its use neglected in chronic diseases. The only reason we have been able to discover for this neglect of a remedy, the merits of which are so well demonstrated and so generally acknowl¬ edged, is that its use is more troublesome and laborious than the use of drugs. A half-dozen purgative pills are taken much more easily than an enema. The administration of a diaphoretic powder is far more convenient than a pack. A blister is easier to manage than a fomentation. But the true physician, who has at heart the real good of his patient, will not sacrifice the safety or comfort of the latter to his own personal convenience. Errors in the Use of Water. — Much of the prejudice against the use of water in treating disease has grown out of abuses of the rem¬ edy, and the putting forward of absurd claims by ignorant persons professing to understand its use. In order to vindicate the character of this powerful curative agent, it is necessary to expose the errors and ignorance of those who have abused it. In the early days of the modern water-cure practice, which was very largely introduced by Priessnitz, cold water was the universal remedy. No matter what the nature of the disease, or the condition or temperament of the patient, the remedy was the same. At the es¬ tablishment of the Graefenberg doctor, ice-cold douches, precipitated from a height of sixteen to eighteen feet, the plunge, directly supplied by the cold mountain springs, and the shower bath of the same tern- HEROIC TREATMENT. perature, were all administered to patients with little discrimination of modifying circumstances, in rooms unwarmed by artificial heat, even in the depths of the coldest mountain winters. As Grsefenberg was the source whence most water doctors of that time drew their knowledge, the same practice was pursued elsewhere. The unreasona¬ bleness of such a course was perceived by the more judicious, and thus, its influence was prejudicial. Heroic Treatment. — Such treatment as that described in the pre¬ ceding paragraph could not result otherwise than disastrously in nu¬ merous cases. The evil effects were sometimes seen at once, but more frequently they appeared after periods more or less remote. In some cases, patients were led to drink twenty or thirty glasses of cold water before breakfast, under the absurd doctrine that the evils of a small excess would be cured by greater indulgence. Hundreds of persons adopted the practice of daily bathing in cold water in a cold room, even in the coldest weather. A few even went so far as to spring from their warm beds on the coldest mornings, run to a neighboring- brook in a state of nudity, and plunge into its frigid waters through a hole in the ice. So infatuated were these enthusiasts that they really thought they enjoyed this refrigerating process ; but, generally, a few years’ continuance of it was sufficient to produce such a “ sedative ” effect upon their systems that some became the victims of consump¬ tion and other constitutional diseases, while others were compelled to discontinue the practice from absolute inability to continue it. A few of the more vigorous were enabled to survive this violent treatment, without apparent injury for a long time ; but those of weaker vital powers soon showed the results of its evil effects. By such processes, together with the cold sitz bath, the dry pack, and other harsh measures, the patient was sometimes brought to the very verge of the grave. Strange as it may appear, those who were formerly the strongest opponents of the use of water, themselves afford the best instances of its excessive use. For instance, in a case of low typhus fever, a “ reg¬ ular ” physician ordered the patient, a young woman, to be immersed in cold water for half an hour. The attendants attempted to carry out the prescription, but in a few moments her symptoms became so alarming that the patient was removed from the bath. It will not be considered remarkable that she died. A prominent New Tork phy¬ sician, a professor of practice in one of the largest medical colleges in 40 626 RATIONAL REMEDIES FOR DISEASE. America, in a report of a case of remittent fever which he had treated with water, said that he administered thirty-five cold packs in a week. The patient died ; but the doctor thought that if he had been more thorough in his treatment, giving more packs and longer ones, he would have lived. Another professor, of a rival college in the same city, cited, in a public lecture, a case of pneumonia which was treated hydropathically by a regular physician of note. The patient, while very feeble; was placed in a cold bath. He was taken out shivering, and died an hour afterward. His conclusion was that water was a very hazardous remedy. We would certainly agree with the profess¬ or’s conclusion if the case cited were an example of the proper use of water. In the preceding case, we will not say that the packs were not beneficial ; but if they had been thus used by a professed hydro- pathist, the treatment would have been pronounced decidedly heroic. Crises. — By the violent processes which have been mentioned, the patient was frequently brought into a condition similar to that pro¬ duced by the old process of depletion by bleeding, antimony, mercury, and purgatives. Painful skin eruptions, boils, and carbuncles, often covered the whole body. Acute pains racked the body of the patient from head to foot. If he survived this “ crisis,” he usually got well, which was regarded as an evidence of the salutary effect of the crisis, and so it became an important object to be attained; and the worse a patient felt, the more certain and speedy, he was encouraged to be¬ lieve, would he his recovery. No account was taken of the immense waste of vital energy during these painful morbid processes. The use of the abdominal bandage, continued for a long time until an eruption is produced, is another means by which some have sought to effect a cure of their patients. This course is pursued under the belief that the discharge occurring from the surface which thus be¬ comes diseased is a vicarious means of removing impurities from the system — an absurd notion which no one acquainted with the first principles of physiology and surgical pathology could entertain for a moment. In many instances the skin is permanently injured by this process, as is evidenced by the appearance of pigment spots. Hydropathic Quacks. — Unfortunately for the reputation of water as a remedy, its use has been largely in the hands of empirics who have used it in a routine manner, and have supposed it to be a cure- all, and the only remedy of any value. At least, such have been the claims made for it. This has served to bring it into disrepute, the dis- A POPULAR ERROR. 627 grace which ought to attach to individuals being applied by an undis¬ criminating public to the innocent victim of abuse. Ignorance. — The greatest bane of all has been the ignorance of those who have professed to be qualified to administer water as a remedy understandingly. Priessnitz himself was an ignorant peasant. He was innocent of either anatomical or surgical knowledge. His slight acquaintance with physiology was gathered by cursory observa¬ tions of patients. Of the effects of water he knew more, studying them with a good degree of acuteness. His lamentable want of knowledge allowed him to fall into many errors. It is related of him that he treated hopeless cases of solid anchylosis of joints just as though they were mere cases of stiffness from rheumatism. Cases of hopeless organic disease he pronounced curable and submitted to long but unavailing treatment, not knowing the real nature of the disease. A young lady died of what he supposed an internal abscess. No ab¬ scess was found, upon which he remarked that “ she had too short a neck for long life.” It is but fair to remark, however, that Priessnitz became more careful and discriminating in later years, and either re¬ fused cases of advanced phthisis or employed cold water in their treat¬ ment with great caution. It could be no wonder that the disciples of such a master should be sadly lacking in many of those qualifications essential for a successful physician, no matter what the remedies employed. The most lamentable feature of the matter is that the same ignorance has continued to be, with few exceptions, characteristic of those who have employed water as a remedy ; this has been especially disastrous be¬ cause a man with the native shrewdness and acuteness of perception of Priessnitz has rarely appeared in the ranks of hydropathists. A Popular Error. — It is a grievous popular error that any one can apply water as skillfully as the most experienced physician, and that its successful use requires no knowledge of the structure and functions of the human body. No doubt this has grown out of an¬ other error, perhaps quite as common ; viz., that water is so simple a remedy that it will do no harm if it does no good. Such notions have frequently led to most disastrous results. Water, as already shown, is one of the most powerful remedies. And while it is, undoubtedly, far safer in the hands of the uneducated than blisters, purgatives, diuret¬ ics, and such agents as opium, chloral, alcohol, and most other drugs, yet it certainly requires careful usage, and the more scientific lcnowl- 628 RATIONAL REMEDIES FOR DISEASE. edge the user possesses, the more skillfully will he be able to apply it. It is, furthermore, true that a great majority of ordinary diseases are commonly so void of danger under careful nursing and hygienic man¬ agement that the application of water is a simple matter which any intelligent mother can perform successfully. A case is related by good authority of a person who fell in apoplexy an hour after taking an excessively hot bath. Another patient became a paralytic from the same cause. Water is a remedy which cannot be safely used by one who has not informed himself of its effects, and of the proper modes of application. It is especially important that the £>eople should be¬ come intelligent in the use of this excellent remedy, since there is no doubt that one of the great obstacles which stands in the way of its general introduction by all intelligent physicians is the difficulty in getting people to carry out with care and accuracy the measures prescribed. Absurd Claims. — Sensible people have been rightfully disgusted with the claims which have been made by certain pretentious persons for the use of water. One declares that the bath will dissolve out of the body mineral substances which have been taken into it. Another claims to have been able, by the application of fomentations to a rheumatic knee, to extract in regular order the ointments which had previously been successively applied. Numerous other claims equally preposterous might be related, if it were necessary. They have all tended to excite a feeling of contempt for a means of treating disease which is really worthy of the highest estimation. Neglect of Other Remedies. — As has been previously remarked, many seem to have forgotten that water is not the only remedy for disease, and not only attempt to cure every disease by its application, but use it to the exclusion of all other remedies. In nearly all cases, sunlight, pure air, rest, exercise, proper food, and other hygienic agen¬ cies are quite as important as water. Electricity, too, is a remedy which should not be ignored ; and skillful surgery is absolutely indis¬ pensable in not a small number of cases. Even drugs are sometimes useful auxiliaries, though doubtless, infinitely more harm has resulted in the past from the employment of drugs in conjunction with water treatment than from their omission. Rational Hydropathy leaves room for every other remedy of value. It does not regard water as a specific nor as a panacea, but only as one of the most valuable of numerous excellent remedies. It discards the EFFECTS OF WATER APPLICATIONS. 629 erroneous and harmful practices of empirics and ignorant charlatans, whether they concern water or other agents, and gives to the aqueous element only its due share of importance. APPLICATIONS OF WATER, The indications which are to be met in the treatment of disease are chiefly those enumerated below ; and how admirably they are met by applications of water may be easily demonstrated by following the di¬ rections given. 1. Equalization of Circulation. — Disease cannot exist without some disturbance of the circulation. In perfect health each part re¬ ceives its due share of blood. One of the first indications in disease, then, is to balance the circulation. If an organ contains too much blood, the application of cold water to the part will occasion contrac¬ tion of the minute vessels of the part, and thus the amount of blood is lessened, as explained more at length in considering the physiolog¬ ical effects of water. Or, the part may be relieved by the application of warm water in some form to adjacent or remote parts of the body, by which means the surplus blood will be drawn to other parts, thus relieving the suffering- organ. Again, if an organ contains too little blood, the opposite course must be pursued. Warm or hot applications are made to the part, while cold applications may be made to other parts if necessary. Very often the two remedies may be advantageously combined, since one part cannot contain too much blood without some other part or parts being deprived of the due proportion, and vice versa : so that while a cold application is needed at one part, the opposite is required at another. 2. Regulation of Temperature. — As the condition of the bodily temperature is closely associated with that of the circulation, the two are usually controlled by the same remedies applied in the same man¬ ner. A part which contains too much blood has usually, also, too high a degree of heat. The cold application relieves both. If the entire surface of the body is involved, the application must be as extensive as necessary to affect the whole. In general fevers, the admirable adaptation of water to this end is well exhibited. When the tempera¬ ture of the body rises above 100°, or even above 98°, a cooling bath should be resorted to. It may consist of a simple sponging with water, scarcely below the bodily temperature, an affusion with tepid water, a 630 RATIONAL REMEDIES FOR DISEASE. full bath of a tepid, temperate, or cold temperature, or some other form of cooling application, according to the degree of cooling effect desired. Any temperature below 98° will be cooling. In general, it is better to employ a bath only a few degrees below the bodily temperature, as its application will not be followed by an increase of heat, called reaction, which follows a brief application of a cool bath. To obtain the proper cooling effects of a cool or cold bath, it must be continued for some time, from ten minutes to half an hour, at least. The same remark applies also to the application of cool baths for the purpose of equal¬ izing the circulation. 3. Removal of Pain. — Pain is usually dependent upon disturb¬ ance of the circulation, being caused by the pressure of overfilled ves¬ sels upon the nerves in a confined space. Pain may be relieved by either hot or cold applications. The first object should be to remove the surplus blood, by local cold applications and remote hot ones. If this plan is not successful, relief will be obtained by a local hot appli¬ cation, which operates by relaxing the surrounding tissues, so that the- nerve fibres are relieved from pressure, as well as by quickening the local circulation, and so relieving congestion. The latter method is. usually most quickly successful ; but it is not so radically curative as the former. Pain dependent on passive congestion will be best re¬ lieved by the method next described. 4. To Excite Activity. — Many organs often become torpid or inact¬ ive, as the skin and liver especially. Sometimes the blood-vessels of an organ become relaxed and inactive, passive congestion resulting. No remedy will so readily induce a return of activity to the affected parts as alternate hot and cold applications, continued for some min¬ utes, fifteen to thirty or more. This is one of the best applications for the relief of old pains. Short applications of cold water in the form of the douche, spray, or ice-rubbing, are also an excellent means of increasing functional activity. 5. Removal of Obstructions. — A very large class of diseases are- attributable to obstruction in various organs, caused by the reception of foreign matters into the system, and the accumulation of the nat¬ ural waste of the tissues. The warm bath, to remove external ob¬ structions, and the internal use of water as a solvent for internal sources of obstruction, are the remedies which will achieve success in nearly all cases. Offending substances in the stomach are readily re- TEMPERATURE OF BATHS. G31 moved by the water emetic ; and hardened accumulations in the large intestine are removed with equal facility by means of the enema. 6. Dilution of the Blood . — In fevers, cholera, and other diseases, the blood often becomes abnormally thickened, dark, and viscid, circu¬ lating with difficulty, and not imparting due nourishment to the tis¬ sues. Nothing but water can remedy this difficulty. It may be got into the blood by absorption from the skin, if the mucous membrane ef the stomach will not absorb it. 7. Influence on the Nervous System. — Finally, it is often im¬ portant to affect certain organs through their nervous centers. Water, properly applied, will accomplish this also. A fomentation applied to the abdomen will often remove headache, and is an excellent remedy for general nervousness, seeming to affect the whole system, just as does galvanic electricity when applied to the same locality, doubtless through the large nervous ganglia located in that region. It is well established that applications to the spine affect the nerve centers in a powerful manner, inducing various and prompt effects in remote or¬ gans. The relaxing, quieting effect of the warm full bath in cases of nervous irritability is well known. Temperature of Baths. — The thermometer is the only accurate measure of temperature ; hence the importance of its use in the administration of baths. Yet the thermometer may be abused. A given temperature may seem warm to one individual and tepid or cool to another. The same difference of sensation will occur in the same individual on different occasions. What seems cool to¬ day will be thought warm to-morrow. The susceptibility of the body to sensations of heat and cold largely depends upon its condition and the temperature of surrounding objects. In consequence of this physiological fact, it is improper to attempt, as some have done, to fix certain exact temperatures at which baths must be given to all per¬ sons under all conditions. For convenience and perspicuity, the temperatures of baths have been divided into six grades, as given in the following table by Forbes; all who attempt to use the bath according to the directions should carefully learn and preserve the distinctions here made : — 632 RATIONAL REMEDIES FOR DISEASE. 1. Cold Bath, 2. Cool, 3. Temperate, 4. Tepid, 5. Warm, G. Hot, OO 0 uO to G0° o o o “ 75° 75° “ 85° 85° “ 92° 92° “ 98° 98° “112° The vapor bath ranges from 08° to 120°; the hot-air or Turkish bath from 100° to 1G0°, or even higher, though not usefully so. A bath of any temperature above the natural heat of the body, 93°, is a hot bath. At 32°, water becomes ice ; a bath is very rarely given at this temperature, and then the application should be made to •only a small surface. Water at 32°, and even ice and snow, may be usefully employed as topical remedies in local diseases. It will rarely be necessary to employ a full bath at a lower temperature than 65°, which will usually seem very cold to the patient. A temperature from ■85° to 95° is the most generally useful for baths which involve a con¬ siderable portion of the body, though of course higher temperatures ■are employed in local applications. How to Determine the Temperature of a Bath without a Thermometer. — It is often necessary to administer a bath when a thermometer cannot be obtained. In such cases it is customary to test the temperature by placing the hand in the water. This is an unreliable method, however ; for the hand becomes, by usage, so ob¬ tuse to heat that water which would seem only warm to it would be painfully hot to the body of the patient. To avoid this source of er¬ ror, it is only necessary to plunge the arm to the elbow into the water, by which means its real temperature will be determined. Water which causes redness of the skin is hot ; when it feels simply comfortable, with no special sensation of either heat or cold, it is warm. Slightly cooler than this, it is tepid. When it causes the appearance •of goose-flesh, it may for practical purposes be called cool, a still lower decree being cold. © © Another Method. — The method about to be described is somewhat more accurate than the preceding, and may be found convenient for facilitating the preparation of a bath of proper quantity as well as temperature, a matter which though simple enough is often quite an¬ noying to inexperienced persons. It is a fact of common knowledge that water boils at 212° F. Boiling water, then, is always of this ADMINISTRATION OF BATHS. G33 temperature. Well and spring water, and the water oil cisterns in winter, does not vaiy greatly from 53°. The temperature of well and spring water changes very slightly with the seasons. By combining in proper quantities water of these known temperatures, any required temperature may be produced. Not having seen this method sug¬ gested before, we have prepared the following table, which may per¬ haps be used to advantage in the absence of a thermometer ; we ad¬ vise all to use a thermometer, however, when it is possible to do so : — Tem. 53 2 o qts. added Tem. 2 to 1 12°. qt. equals o o qts. a o 10G° 91 9 CC cc 1 CC cc H cc cc 98° 3 cc cc 1 CC cc 4 cc cc 93° 4 CC CC 1 CC cc 5 cc cc 85° 5 cc c c 1 cc cc G cc cc 80° G cc cc 1 cc cc 7 cc cc 7G° 8 iC cc 1 cc cc 9 cc cc 71° When larger quantities are needed, it is only necessary to multiply each of the combining quantities by the same number. For instance, if a gallon and a half of water is needed for a foot bath at 106°, pour into a pail or bath-tub four quarts of fresh well water and then add two quarts of boiling water. If four gallons of water are wanted for a sitz bath at 93° (a very common temperature), pour into the bath¬ tub three gallons of fresh well or spring water, and add one gallon of boiling water. Thus any required quantity can be obtained at the temperatures given. The cold water should be placed in the vessel first, and there should be no delay in adding the hot water, as it would rapidly lose its heat, and thus make a larger quantity necessary. De¬ terminate measurement is not essential. The ct)ld and hot water may be added alternately in proper proportions, being measured by the same vessel until the requisite quantity is prepared. RULES FOR BATHING AND THE ADMINISTRATION OF BATHS. The following general rules should be carefully studied and thor¬ oughly understood by every one who expects to employ the bath. Much injury to health and most of the discredit cast upon the use of water as a remedy have arisen from a disregard of some of them. 1. A full bath should never be taken within two or three hours after a meal. Such local baths as fomentations, compresses, foot baths, and G34 RATIONAL REMEDIES FOR DISEASE. even, sitz baths, may be taken an hour or two after a meal; indeed, compresses and fomentations may be applied immediately after a light meal without injury. 2. Employ the thermometer to determine the temperature of every bath when possible to do so; if not, employ the other methods described. 3. The temperature of the room during a bath should be 70° to 85°. Invalids require a warmer room than persons in health. Thorough ventilation is an important matter; but drafts must be carefully pre¬ vented, by screens of netting placed before openings into the room when necessary. 4. Never apply either very cold or excessively hot treatment to aged or feeble patients. Cold is especially dangerous. Hot baths are rarely useful in health. The warm bath answers all the requirements of cleanliness. 5. Never take a cold bath when exhausted or chilly. A German emperor lost his life by taking a cool bath after a fatiguing march. Alexander came near losing his life in the same manner. Many have been rendered cripples for life by so doing. No harm will result from a , cool bath if the body is simply warm, even though it may be in a state of perspiration. Contrary to the common opinion, a considerable degree of heat is the best possible preparation for a cold bath. The Finlanders rush out of their hot ovens — sweat-houses — and roll in the snow, with¬ out injury. 6. Cold baths should not be administered during the period of menstruation in females — unless there is fever with an extremely high temperature. At such times, little bathing of any kind is advisable with the exception of warm or tepid sponge baths, or such treatment as may be advised by a physician. 7. Bath attendants should carefully avoid giving “shocks” to nerv¬ ous people or to those inclined to apoplexy or affected with heart disease. Shocks are unpleasant and unnecessary for any one. 8. Never apply to the head such treatment as will cause shock, as the sudden cold douche, shower, or spray bath. 9. In applying a bath to sick persons, it should always be made of a temperature agreeable to the feelings. 10. The temperature of a warm or hot bath should always be de¬ creased just before its termination, as a precaution against taking cold. 11. Very cold and very hot baths are seldom required. The bar¬ barous practices of half a century ago are now obsolete, or should be if ADMINISTRATION OF BATIIS. 635 they arc not quite discontinued as yet. No good resulted from them which cannot lie attained by milder means, and much harm was occa¬ sioned which is avoided by the use of less extreme temperatures. 12. Those not strong and vigorous should avoid drinking freely of cold water just previous to a bath. 13. The head should always be wet before any bath; and the feet should be warmed — if not already warm — by a hot foot bath, if necessary. 14. A light hand bath every morning will be none too frequent to preserve scrupulous bodily cleanliness. More than a week should never be allowed to elapse without a bath with warm water and soap. 15. One very important element in the success of a bath is the dex¬ terity of the attendant. The patient should be inspired with confidence both in the bath and in the skill of the attendant. The mind has much to do with the effect of a bath. 16. Patients should receive due attention during a bath, so that they may not feel that they are forgotten. Nervous patients often become very apprehensive on this account. It is also important, in most cases, that a reasonable degree of quietude should be maintained. 17. When any unusual or unexpected symptoms appear during a bath, the patient should be removed at once. In case symptoms of faintness appear, as is sometimes the case in feeble patients, during a hot bath, apply cold water to the head and face, give cool water to drink, lower the temperature of the bath by adding cool water, and place the patient as nearly as possible in a horizontal position. 18. In general baths, the patient, unless feeble, will derive benefit by assisting himself as much as possible. 19. The best time for treatment — especially cool treatment — is about three hours after breakfast. 20. In health, a cool or cold bath should be very brief, lasting not more than one or two minutes. A tepid bath should not last more than ten or fifteen minutes. A warm bath may be continued thirty or forty minutes, or even longer, but nothing; could be more absurd than the custom prevailing in some places of prolonging the bath to great length. At Pfeffers and Leuk, in Switzerland, many persons spend the whole day in the water, taking their meals on floating tables, and occupying their time in reading, playing chess, and other games. Some remain in the water as many as sixteen hours out of the twenty-four. Of course, certain baths may be advantageously prolonged in cases of disease ; but 630 RATIONAL REMEDIES FOR DISEASE. no intelligent physician will now recommend the antiquated practice which we sometimes see represented by a patient seated in a tub, with an open book in hand. 21. It is of extreme importance that the patient should be carefully dried after any bath. A large sheet is much better for this purpose than a towel. An old linen or cotton sheet is preferable to a new one, being softer. Full directions are given under the heading, “ Dry Rub¬ bing-Sheet.” 22. A patient should never be left chilly after a bath. Rub until warm. It is equally important that the body should not be left in a state of perspiration, for it will soon become chilly. 23. Patients who are able to do so should exercise a little both before and immediately after a cool bath, to insure thorough reaction. 24. For feeble persons, an hour’s rest soon after a bath will add to its beneficial effects. It is best to go to bed and cover warm. 25. If a bath is followed by headache and fever, there has been something wrong, either in the kind of bath administered, or in the manner of mving it. 26. Always employ for bathing purposes the purest water attain¬ able. Soft water is greatly preferable to hard on many accounts. 27. Patients should not be allowed to become dependent on any special form of bath, as an after-dinner fomentation to aid digestion, the abdominal bandage, or any other appliance. Destroy such a habit if it has been formed. 28. Order, cleanliness, dispatch, and a delicate sense of propriety, are items which every bath attendant should keep constantly in mind, and which will often contribute in no small degree to success in the use of this agent. 29. Never employ a bath without a definite and legitimate purpose in view. It is somewhat customary, in many institutions where water is employed, to apply it in a routine way. Many baths are prescribed for the sake of producing variety or pleasing the patient. A faithful and scientific physician will carefully adapt his remedies to the condition of his patient, and will observe the results. It seems to be a prevalent error that it makes little difference how water is applied, provided the patient is only wet. Warm, hot, tepid, temperate, cool, and cold baths are used indiscriminately. So, also, the different modes of administering baths of the same temperature are disregarded in many cases. In general, each particu- GENERAL BATHS. G37 lar form of bath is especially adapted to the treatment of special con¬ ditions, and it is the best test of the proficiency of a physician, in the use of water, to observe whether he recognizes the distinctions between the various kinds of baths, and is able to adapt them to the appropri¬ ate conditions. Giving too much treatment is likely to be the error into which the inexperienced will fall, rather than the opposite extreme. Nature cannot be forced to do more than she is capable of doing ; and as nat¬ ure must do the healing, if a cure is accomplished, remedies should be of a helping rather than a crowding or forcing nature. The vitality of patients may be expended uselessly by treatment ; for baths excite vital resistance, as well as drugs, a. fact which many overlook. The dangers of over-treatment are not so great as some imagine, however, who take the opposite extreme, and advocate rest as the great cure-all. We have seen patients who seemed to be quite monomaniacs on the subject of “ rest cure,” who needed a good thorough stirring up with useful exercise more than any other kind of treatment. GENERAL APPLICATIONS. Baths applied to the whole surface of the body are, as we have al¬ ready seen, among the most powerful means of affecting the human system either in health or disease. Baths of a temperature less than that of the body, 98°, unless of very brief application, uniformly de¬ crease the bodily temperature. That the diminution of temperature is not merely local, being confined to the .‘.kin and superficial struct¬ ures, is shown by the fact that the thermometer indicates a decline of temperature in the interior of the body as well. The cool full bath, when prolonged, diminishes the production of heat throughout the whole system, besides abstracting large quantities by its contact with the body, as previously explained. The diminution of temperature continues for hours after the bath, in cases in which it was excessively high at the time of administration. Hot baths have, in general, an opposite effect. Swimming. — Swimming is a general bath combined with vigorous exercise, as nearly all baths should be. It is one of the most health¬ ful kinds of exercise, if not continued too long, as it frequently is. The temperature of the water is commonly between 70° and 80°, I., which makes it a temperate bath. Its effects are not far different from other forms of bath of the same temperature. We have not space to 638 RATIONAL REMEDIES FOR DISEASE. devote to a description of the art, since there are valuable treatises on the subject. Plunge Bath. — The hot baths of the ancient Greeks and Romans were usually followed by a plunge up to the neck in a large basin of water four or five feet deep, and large enough to allow the exercise of swimming. Many hydropathic establishments employ the same bath after packs and sweating baths. A bath of this kind is not always attainable without great expense ; and it possesses no particular ad¬ vantage over other methods of cooling the surface after a warm bath. It is a very severe form of bath when employed at a low temperature. In the days of Priessnitz, it was used at a temperature of 45° or 50°. More harm than good would result from a continuous employment of such treatment. The cool plunge should be of but a very few min¬ utes’ duration, and the patient should rub himself vigorously during the bath. In this, as in all other cool baths, the first contact with the water produces chilliness or shock. After two or three minutes, or less, this will be followed by a partial reaction, even while the patient is in the water, accompanied by a feeling of comfortable warmth. This will shortly be again succeeded by a second chill, which is not so likely to be followed by prompt reaction ; hence, the patient should al¬ ways take care to leave the bath before the occurrence of the second chill, if he would avoid unpleasant after-effects. Sponge Bath. — The sponge or hand bath is perhaps the simplest and most useful mode of applying water to the surface of the body; for it requires the use of no appliances which every one does not pos¬ sess, and it can be employed by any one without elaborate preparation, and under almost any circumstances. A great quantity of water is not required ; a few quarts is a plenty, and a pint will answer admirably in an emergency. A soft sponge, or a linen or cotton cloth, and one or two soft towels, or a sheet, are the other requisites. The hand may be used in the absence of a cloth or a sponge for applying the water. The temperature of the bath should not be above 95°, and 90° is generally better. Most people can habitually employ a temperature of 75° or 80° without injury. The use of a much lower temperature is not commonly advisable, and is often productive of great injury. Begin the bath, as usual, by wetting the head, saturating the hair well. Wash the face, then the neck, chest, shoulders, arms, trunk, and back. Rub vigorously until the skin is red, to prevent chilling ; for even when the temperature of the room is nearly equal to that cf the RUBBING WET-SHEET. 030 body, the rapid evaporation of water from the surface will lower the external temperature very rapidly unless a vigorous circulation is maintained. After thoroughly bathing the upper portion of the body, turn the attention to the lower portion, continuing the rubbing of the upper parts at brief intervals to prevent chilliness. As soon as the bathing is concluded, envelop the body in a sheet and rub dry, or dry the skin with a towel. When the surface is nearly or quite dried, rub the whole vigorously with the bare hand. The bath should not be prolonged more than ten or fifteen min¬ utes. Five minutes is sufficient to secure all the benefits of the bath, and even three minutes will suffice for a very good bath. Persons who chill easily will find it better to bathe only a portion of the body before drying it. Some will even find it necessary to retain a portion of the clothing upon the lower part of the body while bath¬ ing and drying the upper part. Weakly patients may receive this bath with very little disturb¬ ance, even in bed. Only a small portion of the body should be uncov¬ ered at a time, being bathed, dried, rubbed, and then covered while another part is treated in a similar manner. The sponge bath may be administered anywhere without danger of soiling the finest carpet, by using care to make the sponge or cloth nearly dry before applying it to the body. A rug may be spread upon the floor as an extra precaution. When used for cleanliness, — as it should be daily, — a little fine soap should be added two or three times a week, to remove the oleaginous secretion from the skin. This bath is applicable whenever there is an abnormal degree of bodily heat, and in such cases may be applied every half-hour without injury, and even oftener. It is useful in cases of nervousness and sleeplessness, in chorea and laryngismus stridulus, also in that curious affection of children known as “catch in the breath.” In fact, when¬ ever water is required in any form this bath may be used with ad¬ vantage, the temperature being suited to the case. Sponging with water as hot as can be borne will often relieve for several hours the profuse sweating of consumptives. Hot sponging of the face, neck, and head are useful in relieving the headache of catarrh and influ¬ enza, and in stopping nose-bleed. nubbin? Wet-Sheet.— See Fig. 196. This bath is administered in two ways ; with the sheet very wet, or dripping, and with it wrung 640 RATIONAL REMEDIES FOR DISEASE. nearly dry. The first method is frequently called the dripping-sheet bath. In giving it, proceed as follows : — • When necessary to prevent injury to the floor or carpet, place upon the floor a large rug or oil-cloth. In the center, place a large wash- tub, in the absence of a more convenient vessel. While the patient is making him¬ self ready for the bath, procure two large cotton sheets. Gather one end of each into folds so that it can be easily and quickly spread out ; lay one upon a chair close at hand, and place the other in the tub. At a distance of three or four feet from the tub, place a low stool. Now place in the tub — if a bath at about 93° is de¬ sired, and this will be the most usual tem¬ perature — half a pailful of fresh well or spring water, and one-third as much boiling water. If a thermometer is at hand it should, of course, be used to test the temperature. After the patient has wet his head, let him step into the tub, facing the assistant, with his arms straight and pressed close to his sides. Now draw up the wet sheet by its gathered end to its full length ; draw out one side quickly, place the corner over one shoulder of the patient, and while holding it in place with one hand, quickly draw the remainder of the sheet around him with the other, bringing it up well around the neck, and folding the second corner under the top so as to hold it in place. But a few seconds should be occupied in applying the sheet. Then commence rubbing the patient vigorously with both hands, one upon each side, rubbing to and fro three or four times in each place, passing over the whole body very rapidly, and then repeating the same, to prevent chilling of any part. Coarse, rob.ust, and phlegmatic people may be rubbed with a good deal of severity; but persons with delicate skin and acute sensibilities require gentler manipulation. After three or four minutes of energetic rubbing, pour over the chest and shoulders a pailful of water four or five degrees cooler than that of the bath, which should be in readiness for instant use. Then rub two or three minutes longer. Now quickly disengage the wet sheet, allowing it to drop into the tub. While the patient is stepping WET-SHEET PACK. 641 upon the stool, quickly grasp the dry sheet, and by the time he is in place, have him enveloped in it. Rub him dry, passing over the whole body several times in rapid succession, to prevent chilling. Care must be taken that every part is thoroughly dried. The head, arm- pits, groins, and feet are liable to escape attention. No moisture should be left between the toes. After wiping nearly or quite dry, apply the hand-rubbing, as elsewhere described, using care not to in¬ duce perspiration by too vigorous or long-continued rubbing. If the akin should become moist from perspiration after having been once dried, gradually lower the temperature of the room and continue light rubbing until the skin becomes dry and cool before allowing the pa¬ tient to dress. Very few baths afford a better opportunity for the display of skill and energy on the part of the attendant than this. Some practice is required to enable one to give it really well. The other form of rubbing wet-sheet is given in about the same manner, the only difference being that the sheet is wrung before its application, and is re-applied one or more times, according as a milder or more severe form of treatment is required. The douche may be re¬ served until the sheet is removed the last time. One precaution especially necessary to be observed in this bath, as well as in all others where a tepid application is succeeded by a cooler one, is frequently overlooked. The second , cooler application shoidd never he made until there is good reaction from the first. This is an excellent bath to apply after packs or warm baths which have induced perspiration, as hot-air and vapor baths. It is especially applicable to cases in which there is defective circulation in the ex¬ tremities, inactive skin and liver, and nervousness. It is of special benefit in cases of debility accompanied with night sweats ; and is an admirable means of removing and preventing muscular soreness and stiffness from severe exercise. Wet-Slieet Pack. — When properly administered, this is one of the most powerful of all water appliances. Some skill is needed to apply it with a uniform degree of success. Two or three comfortables or thick blankets, one woolen blanket, and a large linen or cotton sheet, are the articles necessary. It is important to be certain that the sheet is sufficiently large to extend twice around the patient’s body. More blankets are required in cool weather and by weak patients. Spread upon a bed or straight lounge the comfortables, one by one, making 41 Ii42 RATIONAL REMEDIES FOR DISEASE. them even at the top. Over them, spread the woolen blanket, allow¬ ing its upper edge to fall an inch or two below that of the last com¬ fortable. Wet the sheet in water of the proper temperature, having gathered the end so that it can be quickly spread out. Wring so that it Avill not drip much, place its upper end even with the woolen blanket, and spread it out on each side of the middle sufficiently to allow the patient to lie down upon his back, which he should quickly do, letting his ears come just above the upper border of the sheet, and extending his limbs near together. The patient should then raise his arms, while the attendant draws over one side of the wet sheet, taking care to bring it in contact with as much of the body as possible, bring¬ ing it closely up beneath the arms, and pressing it down between the limbs so as to make it come in contact with both sides of them. Tuck the edge tightly under the patient on the opposite side, using care not to include the other edge of the sheet. Now let the patient clasp his hands across his chest, and then bring up the other side of the sheet. Grasp it by its upper corner with one hand, drawing it down over the shoulder and lengthwise of the body ; then place the other hand upon the covered shoulder, holding the sheet firmly in place while the cor¬ ner is carried upward upon the opposite side and tucked under the shoulder, thus drawing the upper edge of the sheet well up under the chin. Tuck the edge of the sheet under the body, carefully envelop¬ ing the feet. Then bring over each side of the blanket and com¬ fortables in the manner last de¬ scribed, being very careful to ex¬ clude all air at the neck, and al¬ lowing the blankets to extend below the feet so that they can be folded under. It is not desirable that th^ patient should be bound as tightly as a mummy. All that is necessary is the exclusion of air, and as the neck and feet are the points at which it is most likely to enter, these parts should receive particular attention, as directed. If too tightly bound, the patient will be more likely to be nervous than if allowed some freedom. The application of the wet sheet should be made in a few seconds, as it cools very rapidly when spread out. The first blanket should be brought over the patient as soon as possible. If the feet are not warm, a hot foot bath should be taken before the pack. If they WET-SHEET PACK. G43 become cool in the pack, hot jugs, bricks, or stones should be applied to them. If the patient does not become comfortably warm in a few minutes, — ten or fifteen at most, — more blankets should be added, and, if necessary, dry heat should be applied to the sides. If he still re¬ mains chilly, he should be promptly removed and placed in a warm bath, or vigorously rubbed with a dry sheet and then placed in a dry pack. The head should be kept cool by frequent wetting while the patient is in the pack. If a compress is applied, it should be often renewed. The temperature of the pack must depend upon the condition of the patient, being determined by principles elsewhere explained. A woolen sheet is better for the adminif tration of a hot pack than one of cotton or linen. The cold pack is very rarely required. The usual temperature should be about 92°. It is proper to wet the sheet in water of about 100°, as it will be cooled several degrees while being applied. The duration of the pack should be carefully regulated by the condi¬ tion of the patient, the effects desired, and the immediate effects produced. If the patient becomes very nervous, or sweats excessively, or becomes faint, or has other seriously unpleasant or dangerous symptoms, he should be removed from the pack at once if he has not been more than ten minutes in it. Ordinarily, the pack may continue thirty to forty- five minutes. If the patient sleeps naturally, he may remain in the pack a full hour, if strong, or even longer in many cases. In fevers, short packs, frequently repeated, are more beneficial than long ones fewer in number. The pack should be followed by the spray, the sponge bath, the douche, or the rubbing wet-sheet. It is a powerful remedy, and should not be used to excess in chronic diseases ; it has been much abused in this way. Its depurating effects are really wonderful. The increased action of the skin, together with determination of blood to that part, is so great that poisons long hidden in the system are brought out and eliminated. The odor of a sheet used in packing a gross person is often intolerable. If the patient be a tobacco-user, the sheet will be reeking with the odor of nicotine. Many times, the sheet will be actu¬ ally discolored with the impurities withdrawn from the body. The applications of the pack in treating disease are very numerous. In almost all acute diseases accompanied by general febrile disturbance, and in nearly all chronic diseases, it is a most helpful remedy if rightly 644 RATIONAL REMEDIES FOR DISEASE. managed. It is an admirable remedy for nervousness, skin diseases ac- O V companied by thickening of the skin, as psoriasis and icthyosis, and irri¬ tations of the mucous membrane. The warm pack is an invaluable remedy in the treatment of children’s diseases. It is a most successful application in convulsions. Shower Pack. — Fig 198. In many cases of fever in which the temperature rises so high as to produce delirium, the ordinary pack does not seem to be sufficiently power¬ ful to fully control the excess¬ ive heat. In such cases, the shower pack is found of great service. It is thus used in Bellevue Hospital, New York: A rubber blanket is placed upon an ordinary mattress. Upon this, the patient is placed, enveloped in a wet sheet as in the ordinary pack. Instead of being covered with blankets, however, he is left exposed to the air, .so that the powerful cooling effects of evaporation may be obtained. As the sheet becomes warmed by the heat of the body, cool water is show¬ ered upon it from a sprinkler or watering-pot. The bath is continued thus until the temperature of the patient, as indicated by the ther¬ mometer, is sufficiently diminished. This bath, combining as it does the cooling effects of cool water and of evaporation, is the most powerful refrigerant that can be employed ; yet it is perfectly safe when judiciously used, being applied only hi cases of extreme urgency on account of the high temperature. Some practice opening the ordinary pack at intervals, and sprinkling cool water upon the patient, thus obtaining, in some degree, the prolonged cooling effect. The pack must be studied well to enable one to apply it with skill, and certainty of success. Dry -Sheet Pack. — Though this can hardly be called a bath at its commencement, it really becomes a wet-sheet pack before its termination. Its application differs from that of the wet-sheet pack in that the patient is wrapped in woolen blankets instead of the wet sheet. The object of this treatment is to produce perspiration, which may be encouraged by FULL BATH. 645 drinking either cold or hot drinks in considerable quantity, and by the application of dry artificial heat to the feet and sides. It is a very severe form of treatment, and is now seldom practiced. Many years ago, pa¬ tients at hydropathic establishments were often kept for several hours in the dry pack, smothered beneath loads of comfortables, blankets, and feather-beds. If cautiously employed, it is occasionally useful in “ break¬ ing the chills ” in fever and ague. For this purpose it should be admin¬ istered about half an hour before the time for the beginning of the chill. Sweating Pack. — Wrap the patient in woolen blankets. Place to his hands, sides, thighs, and feet, hot bricks, or jugs filled with hot water, wrapped with moist flannels. Beer bottles filled with hot water and covered with wet stockings are very convenient. Give frequent and copious draughts of hot water or some simple tea, as peppermint or win- tergreen, or some similar drink. Keep the head cool by tepid compresses. In a few minutes most copious perspiration will be produced. After bath treat as after pack. Useful in all cases in which powerful action of the skin is desirable, as in chronic rheumatism, obesity, jaundice, etc. It is one of the most excellent means of curingf a 'cold. O Fig:. 199. The Full Bath. Full Bath. — See Fig. 109. For this bath a tub is required the length of the body, about eighteen inches deep, two feet wide at the top, and, preferably, six inches narrower at the bottom. It is better to have the end intended for the head a little elevated. Place in the tub sufficient water so that the patient will be entirely covered, with the exception of the head, when he lies upon his back. During the bath, the body should be vigorously rubbed by the bather or an attendant, or both, particular pains being taken to knead and manipulate the abdo¬ men, in a gentle but thorough manner. The temperature of the bath, when taken for cleanliness, or for its soothing effects, should be not higher than 95° to 98°, aud it should be cooled down to about 85° or 90° before the conclusion of the bath, by the addition of cool water. Very cold baths are used by some, especially in Germany, in the RATIONAL REMEDIES FOR DISEASE. treatment of fevers, so low a temperature as GO3 being often employed. The most approved mode, however, is what is called the graduated bath, in which the temperature is gradually lowered until the desired effect has been produced. When used to excite action of the skin, a hot bath should be em¬ ployed. Begin bath at 98° or 100° F., and gradually raise to 108° or 110°, continuing for 10 to 15 minutes. Then remove the patient, wrap him in blankets, and let him remain sweating two or three hours. Every family ought to possess conveniences for the full bath. In¬ deed, it is now found in every well- resfulated modern house in our large cities. It is not so expensive but that any one can possess it. Portable baths of rubber, see Fig. 200, can be obtained, which are worth many times their cost. A sta¬ tionary bath may be made of wood, of the dimensions given, and lined with lead or zinc. There should be an opening in the lower end for withdrawing the water. Fig. 200. Portable Rubber Bath. The full bath is one of the most refreshing of all baths, being also one of the most pleasant. Employed at a low temperature, it is a pow¬ erful means of reducing excessive heat in fevers. The hot full bath very greatly relieves the pains of acute rheumatism, colic, gall-stones, and sciatica, and is almost a specific for colds, if taken soon after their con¬ traction, j ust before retiring. Immersion in warm water is undoubtedly the best known remedy for extensive burns. Hebra, the renowned professor of skin diseases at Vienna, has kept patients immersed in the warm bath for periods vary¬ ing from two weeks to nine months, with most excellent results, and, he affirms, without interference with any of the vital functions. Eat- ing, digestion, sleeping, and all the functions of life, were performed in the bath without difficulty or interference. Very hot and very cold temperatures are quite hazardous with this bath, since it involves so large a portion of the body. Such extremes are rarely useful in any case, and should not be used except under the eye of a physician. We have found that the cold bath is much better borne if the patient is well anointed with vaseline before being placed in the water. The effects are not diminished. HALF AND SHALLOW BATHS. (347 Half Bath. — See Fig. 201. The half bath is much the same as the full bath. A smaller tub is required, as the bather sits upright with his limbs extended. The water should be at least a foot deep. During the bath, the body should be well rubbed, and water should be poured over the upper portion of the body. Its gen¬ eral effects are nearly the same as those of the full bath, and it may be used for %/ the same general purposes. A little more vigorous rubbing is required to prevent chilling, as so large a portion of the body is exposed. It affords a better opportunity for exciting action in the bowels and abdominal vis¬ cera by shaking, percussing, and kneading the abdomen. Shallow Bath. — Of this bath there are two varieties; sitting shal¬ low and standing shallow. Sitting shallow differs from the half bath in employing less water, and being1 much more vigorous. Its effects and uses are about the same. The bather should rub his limbs and the front portion of his body while the attendant pours water over his chest and shoulders, and rubs vigorously his back and sides. A person can take the bath very well alone by using a rather long coarse towel which can be drawn back and forth across the back by grasping one end with each hand. It is a very valuable means of applying water, and is in con¬ stant requisition in the hydropathic establishments. From 85° to 90° is the proper temperature for this bath. It may be used at a lower temperature in fever cases. At Bellevue Hospital it is applied at about 70° in such cases, and is administered whenever the temperature- exceeds 103°. To avoid the shock of a cool bath, it may be com¬ menced at a temperature little below blood-heat and then gradually cooled by the addition of cool water until the desired temperature is. reached. The reduction of the temperature obtained by this means fully equals that obtained by the sudden application of cold, and the shock and subsequent reaction are prevented. This applies equally to all cool baths as well as the cool shallow bath. The duration of the bath may be from two to thirty minutes. Ten or fifteen minutes will be the usual extent. The standing shallow is in some cases preferred by some to the preceding. The patient stands erect in a varying depth of water 048 RATIONAL REMEDIES FOR DISEASE. from six inches to one or two feet being employed — while his body is vigorously rubbed by one or two assistants, water being poured upon the chest and shoulders at brief intervals. It is a very enliven¬ ing bath. The shallow bath should be completed by a pail douche at a tem¬ perature three or four degrees lower than that of the bath. Affusion. — This consists simply in pouring water over the body of the patient, who may be sitting or standing in a bath-tub. It is a very efficient bath for reducing unnatural heat. This mode of treat¬ ment was used by Hippocrates, Galen, and other ancient physicians. In the last century, Currie, Jackson, and many others used it with great success in scarlatina. It is a sovereign remedy for delirium tre¬ mens, sun-stroke, hysteria, and sometimes of acute mania, when ap¬ plied of the proper temperature. It is used by the Persians in cholera Avith great success. It is useful in drunkenness and convulsions, and has been successfully used in tetanus. Pail Douche.— This bath scarcely differs from the preceding. It consists in the dashing of one or more pailfuls of water upon the body of the bather by an assistant. By means of a proper arrangement, the bather can administer the bath himself. For this purpose, a pail or other vessel filled with water may be suspended or supported above the head of the bather in such a way that it can be quickly upset by drawing upon a string attached to the side. The stream should fall . upon the shoulders, chest, back, or hips, but not upon the head or over the region of the stomach. This bath may be' applied after any warm bath, and should be a little cooler than the bath which precedes it. Whether taken alone or after another bath, it should always be fol¬ lowed by vigorous rubbing. Cataract Douche. — This is a modification of the douche bath, in which a broad sheet of water is allowed to fall upon the body of the bather. The force of the bath depends upon the height from which the water falls, and should be regulated according to the strength of the patient. Almost any one will bear a fall of three or four feet. When the height of the bath cannot be easily modified, it should be of such an altitude as to be well borne by the feeblest patients ; the more vigorous can increase its effects by subjecting themselves to it for a longer time. The observations made relating to the application of the pail douche apply equally well to this bath. SHOWER BATH. 649 Hose Douche. — In this bath, water under pressure is thrown upon the patient from a hose, through a small nozzle. The bather turns his body while the attendant directs the stream upon different parts. It is a less pleasant bath than the spray or other forms of douche. Applied locally, it is a powerful means of causing absorption in en¬ larged glands, as hepatic and splenic enlargements, due to malaria. The alternate hot and cold douche is best for this purpose. Also ex¬ cellent in dyspepsia, applied to the spine opposite the stomach. Its ^enei’al effects are the same as those of the baths mentioned. Shower Bath. — See Fig. 202. This bath is simply an imitation of rain. Water is allowed to fall upon the body after being divid¬ ed into a number of small streams by passing through a vessel with a perforated bottom. Its effects depend upon the size of the streams and the height from which they fall, together with the temperature of the bath and its duration. Although formerly much employed in water-cure establishments, this bath is now less used, especially the cold shower, because its place is supplied by other more con¬ venient ones which produce the same results, as the spray and douche. The best manner of ad¬ ministering it is to commence the application with tepid water, and gradually cool it. The temperature may range from 70 to 95°. The water should not usually be allowed to fall upon the head, but should be received first upon the hands and arms, then upon the feet and limbs, and afterward upon the back and shoulders, the body being well rubbed during the application. Every family possesses in the ordinary colander a means of ad¬ ministering an efficient shower bath, by holding it above the patient and pouring in water of proper temperature from a pitcher. A veiy 650 RATIONAL REMEDIES FOR DISEASE. simple and effective shower apparatus may be obtained at a cost of a few cents. It consists of a vessel of the shape shown in Fig. 203, hav¬ ing a perforated bottom and a hollow handle at the top, open at its upper end. By sinking this vessel into a pail or tub of water, it will be filled, and will remain full when re¬ moved from the water if the finger is placed over the opening in the handle. Upon partially uncovering the opening the water will escape in a shower. The cold shower bath, formerly so common almost everywhere, has been productive of much injury by its in¬ discriminate use, and has brought much reproach upon the use of water as a cura¬ tive agent. None but the most vigorous can enjoy the bath at a lower tempera¬ ture than 70°, and no advantage is gained by its employment at a lower tempera¬ ture than that, while considerable harm '■iWU Fig-. 203. A Simple Shower Bath. may be done in many cases. Spray Bath. — This bath consists in a number of fine streams of water thrown upon the bather, with considerable force. It may be produced by connecting a hose with spray attachment to a force-pump or reservoir from which to obtain wrater under a sufficient pressure. The best form of attachment consists of a hollow double-convex brass or copper piece, one side of which is perforated with fine holes, the other side carrying a rim for attachment to the hose. It is preferable to have an arrangement by which the temperature may be readily and gradually changed from warm or tepid to cool without interrupt¬ ing the bath. In the absence of a proper spray attachment, the appa¬ ratus elsewhere described for the hose douche may be made to an¬ swer a very good purpose, the stream being broken by placing the thumb or finger over the nozzle in such a way as to partially obstruct the flow. This is an excellent bath to follow the pack, vapor bath, hot-air bath, sitz bath, or any other general bath which induces perspiration. It is very agreeable to most persons, and can be applied to feeble pa¬ tients who would be unable to take any more severe form of treat¬ ment. The alternate hot and cold spray is very successful as a means THE VAPOR BATH. 651 of reducing local inflammations. The warm spray is very grateful and soothing to swollen and rheumatic joints; in gout, also, and illy defined, wandering pains, it is an admirable remedy. The cold spray is very successful in the treatment of glandular enlargements, ab¬ scesses, and chronic ulcers, when thoroughly applied. The Vapor Batli . — As a remedial agent, wa¬ ter in the form of warm or hot vapor is scarcely less useful than in its ordinary form. The vapor bath can be readily and success¬ fully administered with such conveniences as every family possesses. Place the patient in a cane-seat chair, having first taken the precau¬ tion to spread over the seat a dry towel. Sur¬ round the patient and the chair first with a woolen blanket, and then with two or three thick comfortables, draw¬ ing the blankets close around his neck, and allowing them to trail upon the floor so as to exclude the air as perfectly as possible. Now place under the chair a large pan or pail containing two or three quarts of boiling water. Let the blankets fall quickly, so as to retain the rising vapor. After a minute or two, raise the blankets a little at one side and carefully place in the vessel a very hot brick or stone, dropping the blankets again as soon as possible to avoid the admission of cold air. Before the first brick or stone has cooled, add another, and so continue until the patient perspires freely. The amount of perspiration must be judged by the face and forehead, as much of the moisture on the skin beneath the blankets is condensed steam. Should the bath become at any time too hot, a little air may be admitted by raising the bottom of the blankets a little, being careful to avoid chilling the patient in so doing. The bath should seldom be continued more than half an hour, and fifteen to twenty minutes will usually accomplish all that is desired by the bath. If too long con¬ tinued, it induces faintness. A too high temperature will be indicated by a strongly accelerated pulse, throbbing of the temples, flushed face, and headache. The head should be kept cool by a compress wet in cool water and often changed. The temperature of the bath should be from 100° to 115°. Unpleasant effects are sometimes produced at 120°. After this bath, apply the tepid spray, rubbing wet-sheet, pail douche, or full bath. No time should be allowed to elapse after the Fig-. 204. Vapor Bath. 652 RATIONAL REMEDIES FOR DISEASE. blankets are removed before the concluding bath is applied, as the patient will chill. He should not be allowed to become chilly by ex¬ posure to cool air before the application of the spray, douche, or other bath, which should be followed by vigorous rubbing. For “breaking up a cold,” “breaking chills,” relieving rheumatism, soreness of the muscles from overexertion, and relaxing stiffened joints, this is a valuable agent. It may also be used to advantage in chronic diseases in which there is inactivity of the skin, liver, or kid¬ neys, being a powerful diaphoretic ; but great care must be exercised to avoid excessive use, as too frequent repetitions of the bath produce debility. This is a milder application than the hot-air bath, unless employed at a high temperature, 120° or more, when it becomes more severe. In institutions where the bath is in daily requisition, a permanent arrangement for giving the bath is usually employed. It usually con¬ sists of a box in which the patient sits upon a stool, his head being allowed to remain outside by a suitable opening. A wet towel is placed around the neck to prevent the steam from rising about the head. See Fig. 204. Steam may be generated by boiling water in the box with a large spirit-lamp or a gas-burner, or it may be conducted into the box by a rubber tube connected with a tight boiler. The Russian Bath. — This bath resembles the va,por bath, the chief difference being that the patient is wholly surrounded by vapor and inhales it instead of having the head out as in the vapor bath. In a large room filled with vapor, marble or soap-stone slabs are so arranged that the patient, by being transferred from one to another, may be ex¬ posed to increasing heat. The temperature employed should be from 100° to 115° F., rarely higher. The effects of the higher tempera¬ tures sometimes employed are in no way beneficial, and are often very harmful. The bath is followed by rubbing with soap and cooling with the shower, spray, or plunge bath. A simple form of Russian bath may be administered in a box or small room prepared for the purpose, which is large enough to allow a person to sit erect, surrounded by the warm vapor, which may be gen¬ erated in a boiler for the purpose and conducted into the bottom of the box by a rubber or metal tube. An opening guarded by a curtain is made in one side to allow the bather to inhale cool air if he should wish to do so, and to give the attendant access to the patient without SITZ BATn. 653 chilling him by the admission of a large quantity of cold air. As in the simpler forms of vapor hath, the head should be kept constantly cool by a cool wet compress often re-applied. Patients troubled with “ rush of blood to the head,” should be further protected by a large cool compress placed around the neck and the upper part of the chest. LOCAL APPLICATIONS. The use of water as a local application is not less important; and is much more varied than its general application. There is no other topical remedy which will produce such a variety of effects and such prompt results. In removing local congestions, subduing local inflam¬ mations, allaying circumscribed pain, and restoring activity to inactive parts, the appropriate applications of water give results which afford both physician and patient a degree of satisfaction which no other sin¬ gle remedy can rival, even electricity, an agent of acknowledged power, not excepted. Sitz Bath.— See Fig. 205. The sitz bath, also known as the hip bath, is one of the most useful baths em¬ ployed in hydropathic treatment. Its utility was fully recognized by the earlier practitioners, who some¬ times kept their patients so long in the bath that they became almost literally water-soaked, and were so numb from the long-continued appli¬ cation of cold water as to possess almost no external sensibility. It is said that in some cases the skin could be rubbed off in the attempts to obtain reaction, without the patient s knowledge. For this bath a common tub may be used, by placing a support under one edge to elevate it two or three inches; but it is better to use a tub made for the purpose, which should have the back raised eight or ten inches higher than the front, to support the back, the sides sloping gradually so as to support the arms of the bather. The bot¬ tom should be elevated two or three irfches. The depth in front should be about the same as that of a common wash-tub. Enough water is required to cover the hips and extend a little vay RATIONAL REMEDIES FOR DISEASE. 654 up the abdomen; four to six gallons will suffice. Any temperature may be employed, being suited to the condition of the patient. The duration of the bath will also vary according to circumstances. A short cool bath is tonic in its effects, like all short cool applications; a more prolonged one is a powerful sedative. The hot sitz is very excit¬ ing in its effects if long continued. The warm bath is relaxing. The hips and trunk should be well rubbed during the bath by the patient or an attendant. The bather should be covered with a sheet or blanket during the bath. If sweating is desirable, use several blankets. The sitz bath should seldom be taken either very hot or extremely cold. A very good plan for administering it, and one which will be ap¬ plicable to most cases, is this: Begin the bath at 92° or 93°. If a ther¬ mometer is not at hand, pour into the bath-tub three gallons of fresh well or spring water, and then add one gallon of boiling water. This will give the desired temperature. After the patient has been in the bath ten minutes, cool it down to 85°, which may be done by adding a gallon of well water. Continue the bath five minutes longer, then ad¬ minister a pail douche or spray, at about 85 °, and wipe dry, as directed after a rubbing wet-sheet. The sitz bath is useful for chronic congestions of the abdominal and pelvic viscera, diarrhea, piles, dysentery, constipation, uterine diseases, and genital and urinary disorders. In treating many uterine and other diseases peculiar to women, it is an indispensable remedy. It is very valuable in various nervous affections, especially those which involve the brain, as cerebral congestion and hyperemia. There is no better remedy for a cold than a very warm sitz bath taken while fasting, and just before retiring. It should be continued until gentle perspiration is induced. The sitz may be converted into a general bath by rubbing the whole body with the wet hand while in the bath, and may thus be made to answer the purposes of the half and shallow baths. Leg Batli. — See Fig. 206. For this bath, a ves¬ sel deep enough to receive the limbs to the middle of the thighs is required. The bath may be taken at any desired temperature; but it is usually employed somewhat cooler than baths which involve the trunk of the body. It is a powerfully derivative bath, and is found very useful to prevent wakefulness in nervous persons, and to Fig. 206. Leg Bath. FOOT BATH AND HALF, PACK. 655 Fig-. 207. Bath. Foot relieve palpitation of the heart, headache, and cerebral congestion. We have found it of great service in the treatment of epileptic patients. It is especially applicable to chronic ulcers of the leg, swollen knees and- ankles, varicose veins of the limbs, and limbs which have suffered by ex¬ posure to severe cold. It gives much relief in gout; there is no danger of causing a metastasis of the disease by the application of this bath. Foot Bath. — See Fig. 207. Any vessel sufficiently large to receive the feet, and enough water to cover them to the ankles, is suitable for this bath. The feet should be rubbed during the bath. If the water is cold, it should not be more than one-fourth of an inch deep. The alternate hot-and-cold foot bath is a very valuable remedy for cold feet, and is an excellent remedy for chilblains. It is given thus: Place the feet in hot water — 100° to 110° — two or three minutes. Then withdraw them and plunge them quickly into a bath of cold water 60° or less. After two or three minutes, restore them to the hot bath. Thus alternate three or four times, and conclude by dipping the feet quickly into cold water and wiping dry. This bath produces most powerful reaction. The foot bath is applicable in the treatment of headache, neuralgia, toothache, catarrh, congestion of abdominal and pelvic organs, colds, and cold feet. It is very useful as a preparatory for other baths, and as an accompaniment of other local applications. Half Pack. — This bath is given in the same manner as the wet- sheet pack, except that the wet sheet extends only from the armpits to the thighs. The blankets are wrapped about the patient in the manner described for the full pack. All the precautions given in connection with the description of that bath are applicable to this. T1 lis bath is frequently employed in cases of patients who are too feeble to bear the full pack, or as a preparatory treatment for that bath. It is much milder than the full pack, and is usually more agreeable to the patient, as it does not confine him so closely. It is a very useful remedy in all inflammations of the abdominal and pelvic organs, pleu¬ risy, acute bronchitis, croup, and pneumonia. A hen a hot application is required, it is well to use a woolen sheet instead of a cotton one. It requires the same after-treatment as the full pack. W hen applied only to the trunk, the application may be distinguished as the body pack, an extremely useful application in fevers. 65G RATIONAL. REMEDIES FOR DISEASE. Chest Pack. — This application is made in the same manner as the half pack, allowing the wet sheet to extend only from the armpits to the ‘navel. The German method of applying the chest pack is to take a strip of cloth about three yards long, and two to two and one-half feet in width, folded lengthwise, and after wetting in cool, tepid, or warm water, and wringing dry as possible, apply as follows : Place the upper edge of one end close up under the arm of the left side. Pass the band¬ age across the front of the body and over the right shoulder, then across the back and under the left arm, then across the chest and under the right arm, then across the back and over the left shoulder, making the end fast in front at the point of starting. A dry flannel cloth is then applied in the same manner, and the patient is wrapped warm in blankets. An excellent remedy in empyema, chronic pleurisy, some forms of asthma, and other pulmonary affections. Leg Pack. — The pack may be applied to the legs with great ad¬ vantage in cases of habitual coldness of the feet and limbs or knees. The same principles mentioned in relation to other packs apply to this. The application should be made either cool or cold, and should extend from the hips downward. It should continue from half an hour to an hour and a half. Chest Wrapper. — This consists of a jacket made something like a vest, reaching from the neck to a little below the navel. It should be made of double thicknesses of soft toweling. To protect the garments or bedding from moisture, it should be covered with another jacket made like it, but a little larger. In applying it, the wrapper should be wet in tepid water, and should then be applied as snugly as consistent with the comfort of the wearer. It should be re-applied every two or three hours, as it becomes dry. The German method described for the chest pack is also used for the chest wrapper, being worn at night only. If properly managed, the chest wrapper is a valuable remedy; but it has been greatlv abused. It should not be worn more than a week without intermission. The practice of some in continuing it until it pro¬ duces an eruption of the skin, and even longer — to promote a discharge — under the idea that a vicarious elimination is thus performed, is highly reprehensible, and has no sound physiological principle to support it. Such treatment is damaging to the skin, and does the patient no good in any way. The better plan is to allow the wrapper to be worn dur¬ ing the night, but omitted during the daytime. If worn during the day it should be changed often, and should be removed as soon as the WET GIRDLE. 057 patient becomes chilly. Whenever removed, the surface of the skin should be washed or sponged with cool or tepid water. Feeble patients with defective circulation should wear the wrapper in the daytime only while walking, riding on horseback, or taking some other form of act¬ ive exercise. This appliance may be profitably employed in a large number of chronic diseases. In chronic bronchitis, pleurisy, pleurodynia, asthma, and the early stages of consumption, it gives relief. Wet Girdle. — This was a favorite remedy with the early German hydropathists, and it is a very useful appliance when properly employed, though it has been much abused bv excessive use, as in the case of the chest wrapper. To apply it well, a coarse towel about three yards long- is the most convenient for use. Wet one-half of this in tepid water, wring until it will not drip, and apply it to the abdomen, placing one end at the side, and bringing it across the front first, so that two thick¬ nesses of the wet portion will cover the abdomen. After winding the whole tightly around the body, fasten the end securely with pins or with tapes attached for the purpose. The remarks made in reference to the wearing of the chest wrapper apply with equal force to the wet girdle. For feeble patients, it is better to wet only that portion of the towel which covers the abdomen. This is a very efficient remedy for constipation, chronic diarrhea, and most other intestinal disorders. It is equally valuable in dyspepsia, tor¬ pid liver, enlarged spleen, and uterine derangements. Ascending Douche. — This modification of the douche is simply an ascending instead of a descending stream. It can be readily managed by constructing a reservoir in such position as to give the water ten or twelve feet fall, when the requisite force cannot be more easily secured. The water is conducted through a hose, and is allowed to issue through a nozzle near the floor. The patient sits or lies just over the nozzle, and a few inches above it. This is a valuable remedy in treating piles, pro¬ lapsus of the bowels or uterus, and constipation. Drop Bath. — Fig. 208. In applying this bath, a vessel with a small opening in the bottom is elevated to a considerable height, water placed in it being allowed to drop upon the part to be treated. The aperture in the vessel should be' only sufficiently large to give egress to a single drop at a time. The bath may also be given by placing in an elevated vessel one end of a skein of cotton yarn, the other being allowed to fall over 42 658 RATIONAL REMEDIES FOR DISEASE. Fig, 208. The Drop Bath. the edge of the vessel and hang below it. By capillary at¬ traction the water will be drawn up into the yarn, and will drop off at the lower end very slowly. This is- a very convenient way of applying water where its cooling effects are required for a considerable length of time, as in wounds, bruises, sprains, and similar cases. It will “ keep down inflamma¬ tion ” in a wonderful manner. It is not commonly necessary that the water should be very cold, as evaporation will keep the part sufficiently cool in most cases. Ann Bath. — See Fig. 209. This is simply holding the arm in water of proper temperature. It is extremely useful in such painful affections as felons, sprains, and nearly all injuries of the hand and arm. Ulcers and acute and chronic skin dis¬ eases of the hand and arm are usually benefited by this bath. If cold water is pain¬ ful, its application should be preceded by that of hot water, or alternated with it. In case of painful felons, the arm must be immersed to the elbow to relieve the pain, although the disease is only in the finger. Head Bath. — The patient should lie upon his back, resting his head in a shallow basin of cool water. The attendant should bathe the fore¬ head, face, and temples, during the bath. The bath may be continued until the heat is removed or lessened. The pouring head bath is often preferable to the preceding. The patient should lie upon a bed or sofa, face downward, allowing his head to extend outward over a tub or other wide vessel, while the water is Fig. 209. Arm Bath. EYE BATH. 659 poured upon the head from a little height, by an assistant. The water may be either hot or cold, according to existing conditions. Very ct Id water is not usually advisable, as its application soon becomes painful, and produces powerful reaction. It should be tepid or temperate. Some cases require very hot water for a few minutes, followed by a slight affusion of tepid water. In hysteria, epilepsy, apoplexy, sun-stroke, acute mania, delirium tremens, and cerebral congestion from any cause, the cold head bath is a promptly efficacious remedy. In many of these cases the pouring head bath is the most effective. The most prompt and almost universal relief will result from the application of the cold douche to the nape of the neck in cases in which persons have had sun-stroke and continued to suf¬ fer from headache and dizziness from exposure to the sun, the arteries and veins of the head and neck being Too full of blood; in all cases of headache confined to one side of the head ; in many cases of roaring or ringing in the ears ; in the crowing respiration of children, or false croup. Eye Bath . — Water may be applied to the eye in various ways. A convenient method when only a brief application is necessary, is to lave the eye with water dipped by the hand. A gentle spray may be applied, or the eyes may be opened and closed in water, thus bringing them freely in contact with the element. Small glass cups made for the purpose may be filled with water and placed over the eye, the water being fre¬ quently changed ; or wet cloths may be laid upon them. In applying water to the eye, it is important to be able to first dis¬ tinguish the exact nature of the difficulty, as much damage may other¬ wise be done by a wrong application. As a general rule, inflammations of the conjunctiva and external structures of the eye require cool or cold applications, while inflammations of the cornea, iris, and other internal structures, require hot applications. This rule is often violated in hy¬ dropathic establishments through ignorance of the structure and diseases of the eye. Cool applications are best made by laying upon the eyes thin folds of linen cloth wet in cold water. Not more than two or three thicknesses should be used, as a thick compress soon becomes warm, while a thin one is kept cool for a longer time by evaporation. The compress should be changed every five minutes at least, when there is much inflammation. The fomentation is as good as any method of applying hot water to the eyes. The application, when hot, should be as hot as the patient can well bear. If it affords relief, continue half an hour or more ; if it in- 6G0 RATIONAL REMEDIES FOR DISEASE. creases the pain, desist at once. The same may be said of cold applica¬ tions also. Alternate hot and cold applications will give greatest relief in some cases. After a hot application, a slightly cooler one should always be applied for a few minutes. A little milk, quince-seed mucilage, or other bland substance, added to the water, makes it more agreeable to the eye in bathing it. The eye bath is applicable in all inflammations and injuries of the eye, and is infinitely superior to all other eye-washes. Daily bathing the eyes in tepid water is a good practice for those who use them much in reading, writing, or other work requiring close attention. Many eyes are ruined by neglect and maltreatment. Ear Bath. — Water applications are made to the ear by means of fomentations, compresses, the dpuche, or the spray. Compresses and fomentations are useful in inflammations of the structures of the ear, including abscesses which often form in the walls of the external canal. Alternate hot and cold applications are use¬ ful in causing the absorption of inflammatory deposits, and thus restoring the hearing. The douche, administered with the syphon syringe, is a valuable means of removing foreign bodies and insects. The warm douche has proved very serviceable in restoring the hearing by removing hard¬ ened ear-wax. In adminis¬ tering the douche, the head should be inclined over a basin, while the stream of water is allowed to issue from the nozzle held close to the external opening of the ear. Violent syringing of the ear should never be practiced, as it may oc¬ casion irreparable injury. Nasal Douche. — This bath is administered either by drawing wa¬ ter into the nose while the mouth is closed, or by injecting it by means Fig:. 210. The Nasal Douche. POST-NA SAL DOUCHE. 061 of a syplion syringe. Great care should always be exercised to ap¬ ply the water gently, as a forcible application will cause pain and irri¬ tation. The nozzle should be pointed straight back, while the head is bent forward a little. See Fig. 210. The patient should on no account swallow, as the water may be forced back into the ear and cause injury to the hearing. Injection should never be practiced with apis- ton syringe, as there is liability of forcing the water into the Eustachian canals. The temperature of the water should be warm or tepid for most applications. Much benefit may be derived by the proper use of this bath in case of acute or chronic catarrh. Water rendered saline by the addition of salt in the proportion of a dram to the pint of water is less unpleasant than pure water, because it is more nearly like the mucous secretion of the nasal membrane. Drawing cold water into the nose is sometimes recommended for hemorrhage from the nose; but it is of doubtful util¬ ity, because the application cannot be continuous, and transient appli¬ cations of cold water are always followed by an afflux of blood to the part so exposed. The hot nasal douche is a much better remedy for nose-bleed. Post-Nasal Douche. — So much harm has been done by the nasal douche that some aurists have been led to condemn its use altogether. For many cases the post-nasal douche is preferable. In this application, the water is injected through a curved tube passed behind the soft pal¬ ate, the fluid being thrown forward and out at the nostrils. More effectual cleans¬ ing is obtained by this method than by the first described, but care must be used to avoid irritating the back part of the throat. An irritation at this point may extend to the ears and cause deafness. The syphon and the fountain syringe are the best for edvinff the nasal douche. The O O former is represented in Figs. 211 and 212. The Uterine Douche. — This very important application of water consists in applying to the uterus through the vagina a gentle stream (TX HI Fig. 211. The Syphon Syringe. GG2 RATIONAL REMEDIES FOR DISEASE. of water by means of the syphon, fountain, or Davidson syringe. The force of the stream should not be so great as to occasion the slightest discomfort. The syphon syringe should be elevated not more than three or four feet above the patient ; in very sensitive cases, less. The position of the patient should be horizontal, with the hips elevated. The length of time occupied in the bath and the amount of water used will depend upon the condition of the patient. In general, we may say that one to four or five gallons should be used. The temperature of the water must al¬ so depend upon the special conditions re¬ quiring treatment. In the great majority of cases it should be from 98° to 108° F. In special cases a higher temperature is required. Cold water is rarely or never required. The vaginal douche is given in essen¬ tially the same way as the uterine douche, the principal difference being that a nozzle hav¬ ing several openings upon the side near the end is employed instead of one with a single opening or two or three smaller ones, at the end. In Figs. 211 and 212 the syphon syringe is shown in readiness for use, together with the different nozzles used for the nose, ear-, and rec¬ tum, in applications to these organs. It will be seen by Fig. 212 that the syringe can be made to supply a large amount of water by con¬ necting it with a pail or other vessel in the manner shown. The uterine and vaginal douche is an indispensable measure of treatment in nearly all diseases of the uterine organs. Its value is far greater than that of any other one remedy in these cases. It re¬ moves congestion, induration, the results of acute and chronic inflam¬ mation, and relieves leucorrhea, and numerous other morbid conditions of these organs. There is probably no remedy for uterine hemorrhage so eminently useful as the hot local douche. It should be applied at as high a temperature as the patient can bear, which will be 106° to ENEMA. GG3 120° F. In surgical operations on these parts we have felt most deeply grateful for the aid received from this useful measure. Enema, — Fecal accumulations in the lower bowel are more quickly and easily removed by an enema of warm water than by any purgative, laxative, or cathartic ever discovered or invented ; and the use of this remedy is never accompanied with the unpleasant and painful griping and tenesmus which often accompany the use of cathartics. The adminis¬ tration is a trifle more troublesome, hut the results are enough superior to more than repay the inconvenience. The syphon syringe is far preferable to any other for administering injections. Water about blood- warm should be used when the purpose is to relieve constipation, and a considerable quantity — one to three pints, or more — may be used. The water should be retained for a few minutes, while the bowels are kneaded and shaken. If there is difficulty in i-etaining the water, a folded napkin should be pressed against the anus. In hemorrhage and inflammation of the lower bowel, cool or cold clysters should he employed, and should he retained as long as possible. The copious cool enema is a valuable antiphlogistic remedy used in conj unction with the cool bath in cases of violent febrile excitement, as typhoid fever, when the temperature rises above 103° F. Large enemas of water, or of water containing quassia, are the best mode of treatment of ascarides, or the so-called seat worms. Large, or what are termed forced, enemata are also recommended by Dr. Mosler as the most successful means of relieving intussusception. They are also recommended in hernia and in the treatment of tape-worm, in connection with other anthelmintics. In catarrh and other diseases of the large intestines they are useful in cleansing and washing away acrid secretions and foreign matters as well as in applying local treatment. A. Rohrick, of Vienna, lias observed that injections of water into the colon increase the fluidity of the bile secreted by the liver. This fact has led to its employment in jaundice due to catarrh of the biliary ducts as well as to other causes, and, according to Dr. Mosler, with successful re¬ sults. In administering a forced injection the syphon syringe should be employed. The patient should lie on his back with his hips elevated, and the enema should be administered slowly. When colicky pains oc¬ cur, the injection should be withheld for a few minutes, until the pain subsides. When it is desired to force fluid into the small intestine, which may be done in case of necessity, the patient should be placed on his knees and shoulders, so as to lift the pelvis as much as possible, and the fluid should be introduced slowly. 6GI RATIONAL REMEDIES FOR DISEASE. The enema is a most perfect substitute for purgatives in general. Cases are very rare in which a cathartic drug will be found necessary if the enema is properly used But the enema may become a source of mischief if abused. If habitually relied upon to secure a movement of the bowels for a long time, the bowels lose their activity, and the most obstinate constipation sometimes results, precisely as from the prolonged use of purgatives. Compresses. — The compress is a wet cloth or bandage applied to a part. The object may be to cool the part under treatment, or to retain heat. The compress may be used with equal success for either purpose. When the part is to be cooled, a compress composed of several folds should be wet in cool, cold, or iced water, as required, and placed upon the part after being wrung so it will not drip. It should be changed as often as every jive minutes. This is often neglected, to the injury of the patient. A very cold compress may be prepared by placing snow or pounded ice between the folds of the compress. This will not need re¬ newal so frequently ; but its effects must be carefully watched, as in¬ jury may be done by neglect. In applying cold to such delicate parts as the eye, a very thin compress is better. It should be renewed once in five minutes, at least. When moist warmth is required, a thick compress is applied, being wrung out of tepid water, and covered with a dry cloth to exclude the air. Soft, dry flannel is an excellent covering. Rubber or oiled silk may be employed when the compress is not to be retained more than a few hours', but if it is to be worn continuously, they will be injurious, as they are impervious to air and thus interfere with the function of the skin. The effects of a compress thus applied are identical with those of the poultice, and the application is a much more cleanly one. Compresses are applicable in all cases in which poultices are com¬ monly used. They mav replace the old-fashioned plasters with profit and comfort to the wearer. The wet-sheet pack, half pack, chest pack and wrapper, leg pack, and wet girdle are all large compresses. When applied continuously in the same place for a long time, the compress occasions a considerable eruption of the skin, and sometimes boils and carbuncles. There is no particular advantage in these erup¬ tions, and they sometimes do much harm by producing a great degree of general irritation. The notion that they purify the system, though a very popular one, has really a very slight foundation. The discharge is largely made up of elements which would be of great utility if retained FOMENT A TIONS. 685 in the system, and the amount of foul matter eliminated in this way is certainly infinitesimal compared with the amount thrown oft’ by a few inches of healthy skin. The skin can always do more and better work when healthy than when diseased. The eruptions are no doubt due to debility of the skin, produced by a too long continuance of the very ab¬ normal conditions supplied by the compress. Yet, strange as it may ap¬ pear, there are those claiming to be physicians who directly aim to pro¬ duce inflamed and irritated surfaces by the continuation of the compress for months and even years. The wet head cap is a compress made to fit the head. It should con¬ sist of several thicknesses of cotton or linen cloth, so as to retain moisture for some time. It is a good temporary appliance in diseases of the scalp, and for headache; but it should never be worn continuously for the purpose of relieving congestion, as it will have an effect just the opposite of that desired. In eczema of the scalp it may be worn until the disease is cured, being frequently re- wetted. It is an excellent means of pre¬ venting sun-stroke and other effects of heat when worn beneath the hat in summer ; but even for this purpose its use should be temporary, the cap being worn only during the hotter portion of the day. Fomentations. — The fomentation is a local application analogous to such general appliances as the hot pack, vapor bath, and hot-air bath. It consists in the application of a cloth wet in hot water. It may be considered as a hot compress. Fold a soft flannel cloth twice, so that it will be of three or four thicknesses. Lay it in a basin, pour boiling water upon it, and wring it dry by folding it in a dry towel. Or, if only one end of the cloth is wet, it may be wrung by folding the dry portion outside of the wet ; in wringing, the whole will become equally wet. Apply it to the patient as hot as it can be borne. The second ap¬ plication can usually be made much hotter than the first. Frequently dipping the hands in cold water will enable the attendant to wring the cloth much hotter than lie would otherwise be able to do. A better way is to fold the flannel as it is to be applied, and then dip in very hot water, lifting it out by the corner and placing it in the middle of a towel. Roll up quickly lengthwise of the towel, and wring nearly as dry as possible by twisting the ends of the towel. In this way the fomentation can be wrung out much hotter than with the hands. Of course it will be too hot to apply to the bare flesh ; but do not waste heat by letting it cool. Protect the skin by one or more thicknesses of flannel and apply at once, covering with another dry flannel. The fomentation CGG RATIONAL REMEDIES FOR DISEASE. will gradually warm through, and will retain its heat two or three times as long as when applied in the ordinary way. A still more convenient way is to heat the cloths in a steamer ; by this means they are made as hot as boiling water, and yet they are more easily handled, not being saturated with water. W hen no hot water is at hand, a fomentation may, in an emergency, be quickly prepared by wetting the flannel in cool water, wringing it as dry as desired, folding it between the leaves of a newspaper, and laying it upon the top of the stove, or holding it smoothly against the side. The paper prevents the cloth from becoming soiled, the water protects the paper from burning, and the steam generated quickly heats the cloth to boiling heat. For a long fomentation, the heat may be made continuous by applying a bag of hot meal, salt, or sand, a hot brick or bottle, or, best of all, a rubber bag filled with water may be used, — covered with a moist flannel. The hot cloths should be re-applied once in five minutes. Two cloths should be employed, so that the second may be applied the mo¬ ment the first is removed. To retain the heat, a dry flannel, rubber, or oil-cloth should be placed over the fomentation. The application may be continued from ten minutes to half an hour, or longer in special cases. This appliance is very powerful, and should not be employed to excess. Alternate hot and cold fomentations are frequently more efficient than the continuous fomentation. Hot applications should be generally fol¬ lowed by a cool or tepid compress for four or five minutes, or the part should be rubbed with the hand dipped in cool water until the redness produced by the fomentation in part disappears. In neuralgia, gout, and chronic rheumatism, in which the cooling has a tendency to cause a return of the pain, the parts should be covered by dry, warm flannels and so protected from the air. By this means the good effect of the ap¬ plication may be prolonged. When applied to the head for some time without intermission, it will often occasion faintness; hence, a cooler application should be made after the use of the hot cloths for fifteen or twenty minutes. If the applications must be continued for a long time, it is well in most cases to apply them at a temperature slightly lower than when they are to be used for only a few minutes. The uses of the fomentation are very numerous. It is indicated whenever there is local pain without excessive heat or evidences of acute inflammation. Local congestions, neuralgia, toothache, pleurisy, pleu¬ rodynia, and most local pains, vanish beneath its potent influence as if APPLICATIONS OF ICE. GG7 by magic. For indigestion, colic, constipation, torpid liver, dys¬ menorrhea, and rheumatic pains, it is a remedy of great power, and is vised with almost uniform success. In relieving sick-headache by appli¬ cation to the head, neck, and stomach, its efficiency is unrivaled. The fomentation is also extremely useful in cases of great loss of blood, in which fatal syncope may be prevented by making hot application to the head and so encouraging the circulation of blood in the brain. Applications of Ice. — Ice may be applied directly to the skin, or, as is usually better, it may be inclosed in flannel, in dried bladders, or better, when dry cold is needed, in a rubber bag. The ice-cap is a double head-cap of rubber, filled with pounded ice. The application of ice is found extremely serviceable in many in¬ flammatory diseases, and in some nervous affections. In inflammation of the brain, the ice-cap is of inestimable value. Ice applied to the spine will check the convulsive spasms of chorea and hysteria when other remedies fail. In putrid sore throat or malignant diphtheria, ice is a sovereign remedy. It should be applied to the neck externally, and held in small bits in the mouth. Small bits swallowed will sometimes relieve the pains of gastralgia. The application of ice is a useful means of checking hemorrhage. It may be applied over the stomach in lueinat- emesis with advantage. It is most effective, however, when it can be applied to the bleeding surface. Applied to the spine it is also most use¬ ful in tetanus, in sea-sickness, in the vomiting of pregnancy, and in cerebro-spinal meningitis. Its use in surgery, in preventing inflamma¬ tion after severe accidents, cannot be overestimated. There is no better remedy for checking the spread of erysipelas. Ice taken internally, by swallowing small pieces of it, Is a useful measure in inflammation of the stomach and in fevers. Some physicians recommend the application of ice to the spine in cases of congestive chill and paralysis. The real worth of such applica¬ tions in these cases has yet to be determined by careful and repeated ob¬ servations. We would not advise an unskillful person to attempt to relieve a violent ague chill by rubbing ice on the patient’s back, and we have some fears that a very skillful operator would hardly succeed to his entire satisfaction and that of the patient; we have, however, obtained good results from the application of ice to the spine in paralysis. The snow bath, applied by rubbing the part vigorously with snow, is a useful application for restoring the circulation to frosted parts. In cases of extreme chilling or absolute freezing, there is perhaps no better 668 RATIONAL REMEDIES FOR DISEASE. remedy. Powdered ice may be used when snow cannot be readily procured. Water-Drinking. — Baron Liebig and many subsequent observers have shown that the internal use of water powerfully stimulates tissue change, both assimilation and disassimilation, or disintegration, being greatly increased. There is usually a greater increase in the building up than in the eliminative processes, so that a person gains weight under the copious use of pure water as a drink. It was, undoubtedly, for this reason that Banting forbade the use of fluids to those suffering with obesity. It is a valuable measure, and ought to be more frequently em¬ ployed than it is. It is an admirable thing to give nature an abundant supply of the great cleansing agent, to wash the tissues free from im¬ purities, and thus remove obstacles to the free play of all the vital func¬ tions. The amount of water to be taken must depend upon the condi¬ tion of the patient and the effect desired. A dyspeptic whose absorbents act slowly, can take but small quantities of fluids, and only a few sips at a time. In general, it is better to take but small quantities at once, and to drink frequently. We have ordered patients to drink two or three quarts a day with advantage to them; but ordinarily, one-third of that quantity is sufficient. Care should be taken, also, to take no large quantity within one or two hours after eating. For “bilious” persons, and those whose bowels are very torpid, one to three glasses of water may be taken in the morning half an hour before breakfast. This should not be done, however, by persons with “ a weak stomach.” The purest water obtainable should be employed, and the temperature should not be too much below that of the body; the temperature of ordinary well water is as low as should be used in any quantity. Iced water, if drank at all, should be taken so slowly that it may be warmed to the temperature of ordinary well water before it reaches the stomach. Copious water-drinking is a very useful measure for patients suf¬ fering from the effects of inactivity of the skin, kidneys, liver, and bowels, and is also eminently useful in cases of defective assimilation. It is a valuable aid in the cure of the tobacco and the opium habit. Cold water, taken frequently, is a most useful means of allaying discomfort and diminishing temperature in fever, when used in con¬ junction with other remedies. Cold drinks also exert a powerful in¬ fluence in exciting action in the kidneys. Warm drinks produce an equally marked effect upon the skin. Hot drinks, in very small quan¬ tity, are often useful in promoting digestion by exciting to action a WATER EMETIC. GG9 debilitated and inactive stomach. The quantity taken for this pur¬ pose should be very small, and it should be taken about half an hour to an hour after eating. The practice should not be long continued, as it will have a tendency to cause increased inactivity on the part of the stomach by producing relaxation of its walls. The fluids drank should not be too hot, not over 102° to 10G°, as they may impair the quality of the gastric juice, besides injuring the mucous membrane of the stomach. When water alone is insipid and is not readily absorbed, the juice of limes, lemons, or other acid fruit may be added. Water Emetic. — Warm water at about 92° — not hot water — is a most excellent emetic if taken in sufficient quantity. It is prompt in action, and is unaccompanied by the painful nausea, retching, and straining produced by most other emetics. From half a pint to a quart is required to produce emesis. The patient should slowly swal¬ low a tumblerful ; then, after two or three minutes, swallow another, so continuing to drink for ten minutes or more. As soon as the slightest disposition to vomit is felt, — or even if it is not felt, after a considerable quantity of water has been taken, — the patient should touch the back part of his mouth with the end of his finger or a feather, as far down as he can reach. This will usually excite the de¬ sired action. If it does not, all that need be done is to continue drink¬ ing. A little salt added to the water will make it more sickening, and will do no particular harm, as it is thrown out again. It is not claimed that the warm- water emetic can replace all other emetics in all cases. When instant vomiting is necessary, as in cases of poisoning, some more prompt emetic may be used with it. But for all ordinary purposes it clearly has no rival. Local Applications of Vapor. — Warm vapor may be used to ad¬ vantage in the treatment of swollen joints and painful parts, especially the different forms of neuralgia. The inhalation of warm vapor is a sovereign remedy in true croup, and is of immense value in nearly all acute and chronic affections of the air-passages, in diphtheria especially, and also in pulmonary consumption in certain stages. In some cases its efficiency is much increased by the addition of some volatile substance, as will be noticed elsewhere under the head of inhalations. Local applications of vapor can be made in various ways ; but the best are those described in connection with the subject named, when the applications are to be made to the throat or nasal cavity. When the 670 RATIONAL REMEDIES FOR DISEASE. application is to be made to other portions of the body, it may be effected by means of rubber tubes connected with a suitable boiler. A vapor-bath apparatus generally comprises arrangements that can be used for this purpose. By inclosing the end of the rubber tube in a flannel cloth a continued fomentation may be administered. Applications of Water ill Surgery. — No other remedy is so uni¬ versally useful in surgery as water. As a dressing for wounds, cool or tepid, it is applicable to nearly all accidental and surgical wounds. Used either very cold, — as in the form of ice, — or very hot, at a temperature of 106° to 120° F., it is the most effectual means of stopping hemor¬ rhage, not requiring the ligature of arteries. Its utility as a remedy for extensive burns has already been referred to under the head of “Full Bath.” A few years ago Dr. F. H. Hamilton, of New York City, then professor of surgery in Bellevue Hospital Medical College, called attention to the fact that immersion in warm or hot water was the most effectual means of preventing inflammation, gangrene, or mortification, and promoting the healing of severe injuries to the limbs. By this means he saved many limbs which must otherwise have been sacrificed, and many lives as well. The practice has now been em¬ ployed by so many others that its utility is fully established. When not convenient to immerse parts, they are kept covered with thick layers of sheet cotton, which are kept saturated with warm water. The temperatures usually employed are 90° to 106° F. No remedy, is so excellent for bruises and lacerations as hot fomentations. When applied immediately after the accident they will often prevent sore¬ ness and discoloration almost altogether, hence their applicability in such cases as bruises upon the face and hea^ or other exposed parts of the body. MISCELLANEOUS BATHS. Under this head we shall include a number of different bath ap¬ plications, in most of which other substances besides water enter, some of neutral character, others possessing properties which occasion con¬ siderable irritation or stimulation of the skin. Among these may be mentioned as one of the most commonly used — Sea-Batliing. — Bathing in the sea is much practiced by fashiona¬ ble people who make annual visits to the sea-coast for this purpose. It is no doubt useful, though many who participate in it would doubt¬ less receive quite as much benefit if they took as many baths at home MINERAL - WATER BA THS. 671 during the whole year as they take at the fashionable watering-places in a single week. It is a tine thing to be well washed once a year, however, if not more often. As generally conducted, sea-bathing is usually not more beneficial than harmful. The dissipation accompanying it more than counter¬ balances what good might be gained. It is rather absurd to attribute any specific virtues to sea-water, as many do. Quite a large business is carried on in the evaporation of sea-water and the sale of the resi¬ due, which is again dissolved in water and used in bathing by those who live too far inland to enjoy the benefits of bathing in the sea, or who prefer to take their sea-bath in their own private bath-room. Everything must have a counterfeit, and so this sea-salt is imitated by base swindlers who prepare a mixture of chemicals just as powerful, but not quite so complicated, though certainly equally good. All of this trouble and swindling might be saved if people would only con¬ sider for a moment the fact that the chief benefits they receive from sea-bathing are derived from the exercise, the temperature, and pure water, and not from any impurities which the water may chance to contain. At any rate, the same effects may be obtained by adding a liberal quantity of salt to ordinary water employed in bathing. This we frequently do, especially in cases of night-sweats, or of great inac¬ tivity of the skin. Sea-bathing is usually overdone. More benefit will be gained by one or two daily baths than by a half-dozen. Fifty baths in a single week are not equivalent to a single bath each in fifty weeks. Mineral-Water Baths. — Water containing in solution salts of iron, magnesia, or other metallic elements, as well as sulphur, arsenic, iodine, or any compound of these or other elements which are capable of imparting a nauseous or saline taste, an unpleasant odor, or medic¬ inal properties, has been much employed for the cure of all sorts of chronic ailments. Such waters are totally unfit for general use for drinking or cooking purposes, and certainly possess no particular ad¬ vantage as cleansing agents. Whether they are useful as medicines is a medical question which we do not purpose to consider here ; but one would naturally suppose that water which is unfit to cleanse the out¬ side of the body could not be of very great utility as an internal application. No doubt a great many people are benefited by visiting places of this sort, but it is quite probable that at least a large share of the ben- G72 RATIONAL REMEDIES FOR DISEASE. efit is derived from the change of scenery, the rest from business, study, or care, together with the influence of the imagination, and the therapeutic influence of bathing, independent of the quality of the water. We would hesitate long before sending a patient to a mineral¬ spring establishment, for two reasons : 1. So far as the specific virtues of the water are concerned, we could supply the same mineral constit¬ uents in more agreeable form if we deemed best for him to employ those compounds ; 2. Almost without exception, those institutions are in the hands of men of very limited medical education. Many of the managers of mineral springs have no exact knowledge of the science of medicine whatever. In short, they are quacks, and utterly incom¬ petent to undertake the professional management of any invalid’s case. In consequence of this ignorance on the part of managers, patients are often allowed to do themselves very great injury by excessive drink¬ ing of saline and other waters, by too frequent repetition of baths, and by the employment of baths at improper extremes of temperature. It is an interesting fact in this connection that many of the springs which have attained most notoriety for curative virtues on account of supposed special properties in the water afforded by them have been found, upon examination by experts, to be in no way peculiar except in the remarkable purity of the water furnished by them. It is an equally interesting fact that very soon after the announce¬ ment of the extreme purity of the water of any spring, its fame be¬ gins to wane, and its waters shortly lose their reputation altogether. A pure-water spring in Maine was for a number of years resorted to by thousands of invalids, thousands of barrels being also shipped away for use in other parts of the country. When a Boston chemist dis¬ covered that all the solid constituents — remedial or otherwise — of a gallon of the water could be held upon the point of a penknife, its notoriety speedily diminished. Robley Dunglison, an eminent medical authority, taught that the beneficial effects derived from the use of mineral waters were the re¬ sults of “ corrected habits of life, the change of air and scene, the rest from labor or dissipation, and the increased amount of aqueous fluid imbibed, which are always associated with the springs.” With this we fully agree, as also with the views held by the able editor of the Detroit Lancet, who remarks as follows on this subject : “Topers, glut¬ tons of full habit, chronic rheumatics, etc., who are full of waste ma¬ terials, effete matters, are benefited by drinking large amounts of any THE OIL-BATH. 673 bland water. Their sewers need flushing, and to guzzle from a spring is more fashionable than to do the same thing from the well at home.” This view is still further confirmed by the testimony of Dr. E. Dewey, an eminent physician of Vienna, who in a recent lecture “ proved that the human skin is completely impenetrable to the chem¬ ical contact of mineral waters, and that therefore the explanation of the effects of baths in these waters at the numerous bathing-places has to be sought exclusively in the domain of physics, and not in that of chemistry. This important discovery annuls all common views- re¬ garding the bathing cures effected by the various mineral springs, and explains in the simplest manner that, from a chemical point of view, the action of the most opposite waters must be one and the same.” The Oil-Batli, or Inunction. — Inunction was greatly practiced by the ancients in connection with the Roman and Turkish baths. It con¬ sists in rubbing the skin very thoroughly with some unctuous sub¬ stance. Olive-oil may be employed, but cosmoline and vaseline, re¬ fined products of coal-oil, are much preferable. Olive-oil cannot be obtained pure except at almost fabulous prices. That sold in the drug¬ stores as olive-oil is really cotton-seed oil and mixtures of lard with various other vegetable oils. We have found pure refined cocoanut oil to be the best of all oils for this purpose. A warm bath should first be administered. Then dry the patient, as usual, and apply the unguent, taking care to rub it in thoroughly. Simply greasing the surface is not the object sought. The skin and flesh should be worked, rubbed, and kneaded until the oil nearly dis¬ appears from the surface. The skin should then be wiped clean with a soft cloth. The object of this application is to supply the place of defective natural secretion of oleaginous material, to increase the activity of the skin, and to diminish susceptibility to cold. How this is accomplished, readily appears. The oil is a simple substitute for the sebaceous se¬ cretion, which is, in a certain class of diseases, notably deficient. The thorough manipulation of the skin which is necessary in applying the oil, and which is facilitated by a lubricant, directly promotes cutaneous activity. Whether the oil itself has any direct effect in increasing the functional activity of the skin cannot be positively affirmed, although it is reasonably supposable that the skin would act more nearly nor¬ mal when a deficient element is supplied than when it is wanting. Recent experiments have shown that the skin radiates heat faster 43 RATIONAL REMEDIES FOR DISEASE. ‘<374 '•when varnished or anointed, and this may account in part for the warming effect of the inunction, as also for the protection which it af¬ fords against taking cold after warm baths, as the warm full bath, or the hot-air, Russian, vapor, or Turkish bath. More than thirty years ago, Dr. Taylor, of London, and Dr. Schnee- man, of Germany, published the results of experiments in the use of unguents in the treatment of disease, which attracted some considera- ble attention at the time, and have since been confirmed by the ob¬ servations of numerous other physicians. We quote the following from the work of Dr. Taylor, which appeared in 1S50 : — ■ “ Fever assuming all the typhoid symptoms will be found to change its character completely under this treatment in twenty -four hours. It especially soothes the nervous system, procures sleep, lessens the frequency of the pulse, and correspondingly the thirst. The pulse may be reduced from 120 to 90 in a few hours, after a few applica¬ tions of the ointment. It corrects the fetid and offensive odors aris¬ ing from patients. Contagion seldom spreads after its use, very rarely uven in crowded rooms ; when early employed, the fever is prevented from running into the continued type, and the patient soon becomes convalescent. Finally, it should be observed that it is always at com¬ mand, perfectly safe, harmless, and is perhaps never contra-indicated.” All of the results claimed by Dr. Taylor have been confirmed by many others. We have found it of great value in the treatment of consumptives, dyspeptics, diabetic patients, and all classes of invalids suffering with dry or inactive skins. It will sometimes produce al¬ most marvelous results in the cases of infants that seem to be wast¬ ing away without adequate cause. A few applications will not infre- ■ quently occasion a very apparent change for the better which will con¬ tinue until the child is restored to health. We have also found the remedy of great value in the treatment of scarlatina, measles, diphthe¬ ria, and different forms of diseases of the skin. It is very serviceable also in lowering the temperature in typhoid and typhus fevers, pneu¬ monia, and, in fact, all febrile disorders. It is particularly applicable in the treatment of small-pox, alleviating the suffering of the patient vby soothing the skin and lowering the temperature. It is believed, -also, to have the effect of lessening the liability of pitting and of com¬ municating the disease to others. Some prefer for use in small-pox and scarlatina a mixture of equal parts of olive-oil and lime-water, or carron oil, a mixture which we have used with satisfaction in eruptive NOVEL BATHS. 675 fevers. Inunction has also been used with success in tetanus, beincj applied particularly to the spine. It will be found of very great serv¬ ice in preventing bed-sores in patients long confined to their beds, for which purpose it should be applied once or twice a day. Novel Baths. — Many strange substances have been used in the form of a bath, by various nations at different periods, only a few of which are worthy of attention, and those more on account of their novelty than for any practical value which they possess. The Milk Bath. — With some of the ancient Roman emperors and empresses milk was largely employed as a fancied means of preserving health. It was supposed to have a specially beneficial effect upon the skin. It is still used somewhat for the same purpose. Mud Bath. — Immersion of the body in warm mud has been a fa¬ vorite practice at several places in Italy, France, Germany, and other countries. The effects are not very different from those of any warm bath, and are said to be very pleasant, by those who have taken them. If the mud were not medicated, this kind of bath would not be espe¬ cially objectionable for those who could enjoy it. In some instances the mud contains saline and other elements which have a decidedly stimulating effect upon the skin, sometimes even amounting to irrita¬ tion. Peat and turf are used for the same purpose in Germany, being made into a poultice which is smeared over the body. Earth Bath. — Burying the body in the moist earth has also been practiced. We have known of one instance in which this remedy was successfully used in the treatment of ague. Sand baths are employed in Blankenberg and Norderney, a hole being dug in the sand and the patient being placed in it and the sand shoveled around him. Spanish sailors used to treat yellow fever by this method ; with what success we are not aware. Bees eggs, blood, xuine, pitch, and gelatine have also been em¬ ployed by different nations, at different periods, in bathing. None of these applications are superior to pure water, which all nature rec¬ ognizes as the proper material for bathing purposes. THERAPEUTICAL APPLICATIONS OF TEMPERATURE. In nearly all of the various applications of water to which we have called attention, thermal influences play a large part. In fact, most applications of water affect the body beneficially or otherwise through (376 RATIONAL REMEDIES FOR DISEASE. / their influence in the modification of temperature. In this section we shall notice only such thermal appliances as have not been already noticed in connection with the description of the several baths. APPLICATIONS OF HEAT. The therapeutic indications of heat may be inferred from what has already been said of its physiological action, or influence upon the body in health, so that we need not dwell particularly upon the indi¬ cations for the use of this important agent, and we shall proceed at once to describe some of the modes of applying heat in which it seems to be the only factor in the effects produced, or what is sometimes termed dry heat. The Turkish Bath. — In taking this bath the patient is placed in an atmosphere of dry air heated to a temperature of from 120° to 180° F. The bathing apartments usually consist of two or three rooms which are maintained at different temperatures, so that a person may by passing from one to another become gradually accustomed to the extreme heat to which he is exposed before leaving the bath. The room first entered from the dressing-room has a temperature of 120° to 140° F. After remaining in this room for a time, reclining in an easy- chair or upon a sofa, the bather passes into the second room, where the temperature is 150° to 170° F. Sometimes a third room is added in which the temperature is 200° to 240° F.; but this degree of heat is rarely if ever required. The temperature of the bath need not exceed 140° to secure all the good results which can be derived from it, and 170° is much safer than higher temperatures. The first sensation upon entering the hot, dry atmosphere is to a novice in the use of the bath usually not pleasant ; but soon he begins to perspire freely, and the unpleasant symptoms disappear. The pro¬ fuse perspiration loosens the epidermis, and prepares the patient for the subsequent processes of the bath. After having remained in the bath until the perspiration has been thoroughly established for the de¬ sired length of time — varying, of course, with the effect required — the patient is conducted into a room a few degrees lower in temperature, preferably not much above or below 100°, where he is placed on a marble slab and thoroughly rubbed, kneaded, and otherwise manipu¬ lated by an attendant for the purpose of removing the dead epidermis and effete matters deposited upon the skin. After this process is thor¬ oughly performed, the attendant applies a thick lather to the whole THE TURKISH BATH. 677 surface of the body, and rubs or scours the skin with a flesh-brush or with the hand. In Eastern countries the flesh-brush is not used, and we believe that in general it is unnecessary and often harmful to the skin. After this thorough rubbing and shampooing, the patient is by means of the shower and spray baths gradually cooled to the normal temperature. Usually, after the spray, the bather completes this bath by a plunge in cool water. The latter is unnecessary, however, and on some accounts is objectionable. The graduated shower and spray are milder and better means of securing all the toning up of the super¬ ficial blood-vessels necessary. After being thus cooled, the patient is quickly dried with towels and then enveloped in a sheet, and, if necessary, a blanket also, and lies down to cool in a room in which the temperature is maintained at 70° to 80°. After becoming well cooled, he dresses himself, and the bath is complete. The time usually occupied in the bath is one to two hours. Water should be taken freely before and during the bath to supply the loss by per¬ spiration. While the heated air is the chief agent in the bath, the rubbing and other manipulations, and the spray and shower baths also, produce bene¬ ficial effects. The Turkish bath is one of the most powerful diaphoretics known, and stimulates elimination in a most marked degree. It may be used in such a way as to either diminish or increase flesh. It is a sovereign remedy in acute and chronic rheumatism, rheumatic gout, obesity, dropsy, jaundice, malarial and syphilitic diseases, and numerous other affections. We have broken up what appeared to be typhoid fever in its first stages, with two or three Turkish baths, and consider the rem¬ edy almost a specific for remittent and intermittent fevers. Its value in some forms of skin disease, particularly psoriasis and mingled psoriasis and eczema, is very great. It has also been used with success in hydrophobia. The Roman bath is the same as the Turkish, except that after the patient has been dried after the spray or plunge he is thoroughly rubbed with some sort of unguent. Sweet-oil and vaseline are most often used ; we have found a fine quality of cocoanut oil superior to any other. After much rubbing and kneading, which is greatly facilitated by the inunction, all remains of oily matter which have not disappeared from the surface are removed by a towel. Persons who have a very defective circulation and take cold easily are benefited by the Roman bath much more than by the Turkish. It is also a better bath for en- courairino- assimilation. o o 678 RATIONAL REMEDIES FOR DISEASE. Hot-Air Bath . — In administering this bath, prepare the patient precisely as directed for the vapor bath. Instead of placing under the chair a vessel of hot water, place a large alcohol lamp or a small dish containing a few ounces of alcohol. When all is ready, light the lamp or alcohol, and ^carefully exclude the air. It is hardly necessary to sug¬ gest the propriety of putting the lamp in such a position as to insure safety from fire. If alcohol is used in an open dish, it is important to wipe the outside of the vessel quite free from any trace of the fluid, as otherwise it might be communicated to the floor or carpet. Also avoid spilling the alcohol in putting the lamp or dish in place, for the same reason. It is a wise precaution to put the lamp or dish in a plate or shallow dish containing a little water. The hot-air bath should be con- ducted in the same manner as the vapor bath ; but the patient will bear much higher temperatures, as air is a much poorer conductor of heat than vapor. A heat of 130° to 160° F. is not at all disagreeable to the patient. It should be followed by cooling baths as directed for the vapor bath. When perspiration is not readily produced by the hot-air or Turk¬ ish bath, the patient should be given a hot full bath or spray bath from three to five minutes and then again exposed to the hot air, when per¬ spiration will start quickly. The vapor bath may be used for the same purpose. This bath is useful for all cases for which the vapor and Turkish baths are recommended, and is more convenient for use in families, as it can be improvised so readily. It cannot be excelled as a diaphoretic, and is an excellent means of eliminating the poison of malaria, syphilis, and hydrophobia. An English naval surgeon reported through the British Medical Journal, a year or two ago, a large number of cases of syph¬ ilis successfully treated by the hot-air bath combined with careful diet. Local Applications of Dry Heat. — The use of fomentations is often less convenient or desirable than dry applications of heat, which may be made in a variety of ways. Bottles, jugs, or rubber bags, filled with hot water, hot bricks or stones wrapped in papers or cloths, hot cloths, bags filled with hot sand, salt, or corn meal, are all convenient methods of applying dry heat. A few suggestions with reference to the manner of using hot appli¬ cations may be useful. In applying heat to the feet when the circula¬ tion in those organs is defective, it is frequently insufficient to apply the heat only to the bottoms of the feet. For this reason, jugs or bottles and stones are often applied without effecting any satisfactory results.. APPLICATIONS OF DRY COLD. G7(J' A much more efficient method is the following : Heat to a suitable tem¬ perature two or three pounds of com meal or salt. Place the salt or meal in a bag sufficiently large to envelop the feet. After distributing it evenly through the bag, wrap the latter about the feet and cover them with a woolen blanket. A rubber bag partially filled with hot water is an excellent appliance for use in cases of neuralgia, toothache, and nearly all acute pains in the region of the head, as it will conform so perfectly to the shape of the part to which it is applied, and may be used as a pillow. As a general rule, hot applications should not be continued more than an hour or two, at longest, without, at least, a transient applica¬ tion of a lower temperature. Too prolonged an application may result in injury to the part. APPLICATIONS OF COLD. Dry cold applications may often be made when moist cold is not well borne. In such cases, cold water may be used in bottles, jugs, or rubber bags ; or pounded ice in¬ closed in dried bladders or in rubber bags may be employed. For persons who are troubled with burning of the feet at night, cold bottles or jugs afford as much comfort and relief as do hot bags, bricks, etc., to those who suffer from the op¬ posite cause. Dry cold applied by means of the syphon bag, as shown in Fig. 213, is an excellent means of controlling hemorrhage of the lungs, or restraining inflammation in pneumonia. Freezing. — By means of freezing, parts may be rendered wholly in¬ sensible to pain, so that slight surgical operations may be easily per¬ formed. When the freezing is long continued, the frozen parts may lose their vitality entirely, which will cause them to slough away. By this means, excrescences, — as warts, wens, and polypi, fibrous and seoa- ceous tumors, and even malignant tumors, as cancer, may be successfully Fig\ S13. Application of Continuous Cold to the Chest, in Hemorrhage of the Lungs or Pneumonia- 680 RATIONAL REMEDIES FOR DISEASE. removed. Small cancers may sometimes be cured by repeated and long- continued freezing. Their growth may certainly be impeded by this means. A convenient mode of application in cancer of the breast is to suspend from the neck a rubber bag filled with pounded ice, allowing it to lie against the cancerous org an. o o Fig. 214. Double Bag for Applying Continuous Cold to the Knee. Fig. 215. Ice Head-Cap. Freezing may be accomplished by applying a spray of ether, by means of an atomizer, or by a freezing mixture composed of ecpial parts of powdered ice and salt or two parts of snow to one of salt. Mix quickly, put into a gauze bag and apply to the part to be frozen. In three to six minutes the skin will become white and glistening, when the bag should be removed. Freezing should not be continued longer than six minutes at a time, as the tissues may be harmed, though, usually, no harm results from repeated freezing if proper care Is used in thawing the frozen part. It should be kept immersed in cool water, or covered with cloths kept cool by frequent wetting with cold water, until the natural feeling is restored. Felons may often be cured, especially when they first begin, by freezing two or three times. Lum¬ bago and sciatica, as well as other forms of neu¬ ralgia, are sometimes almost instantly relieved by freezing of the skin immediately above the painful part. We have cured some obstinate cases of sci¬ atica by this means after other remedies had failed. 216. Spinal Ice- Bag. THE AIR-BATH. 68 i AEROTHERAPY, OR REMEDIAL APPLICATIONS OF AIR. In its broadest sense, aerotherapy includes all remedial applications in which the atmosphere is made the chief agent. In the Turkish and hot-air baths it of course plays a necessary part, but the chief effect is obtained by the application of heat through the medium of the air. That the atmosphere itself is a powerful medium of affecting the sys¬ tem beneficially or otherwise, is evidenced by a large number of facts well known to every one, as the influence of climate, altitude, and other familiar means of securing what is termed “ a change of air.” It is not, however, to these applications of air that we wish now to re- fer, but rather to more specific uses of the element, and methods that may be made use of in all latitudes alike. Aerotherapy is still in its infancy, but enough facts have been determined and tested by experi¬ ence to warrant the conclusion that the air is a potent therapeutic agent for use in certain classes of cases at least. Air-Bath. — The air has a very soothing effect upon the body when allowed to come in contact with the entire surface. It answers a very valuable purpose when a water bath is impossible, or when the patient is too feeble to endure the application of water. A sleepless person will often fall into a sound and refreshing slumber after walking a few minutes in his room with the whole body exposed to the air. The effects of night labor upon literary people may be partially counter¬ acted by the air-bath. Benjamin Franklin was accustomed to pursue his writing to a late hour after divesting himself of his clothing, and he recommends the practice to others Compelled to labor late with the pen. The Use of Compressed and Rarefied Air. — What is known as the Pneumatic treatment, which consists in the use of compressed and rarefied air, has become quite popular in France and Germany within a few years. This treatment has been little employed, however, in this country, its use having been conflned almost wholly to irregular practitioners and quacks, who have employed it in a form which is known as the vacuum treatment. This treatment consists in expos¬ ing either the whole or a part of the body to air which has been either compressed or rarefied. In the application of compressed air to the whole of the body the patient is placed in a small room constructed for the purpose, into G82 RATIONAL REMEDIES FOR DISEASE. which air is admitted until a pressure of one and one-half or two at¬ mospheres is obtained, the air being withdrawn as rapidly as needed to remove the products of respiration. The patient sits or lies in this room from one or two hours to several hours, according to the effect desired. A cabinet of this kind, such as is employed in Paris, is repre¬ sented in Fig. 217. In the cabinet described, the patient may be subjected to the influence of rarefied as well as compressed air ; hut the use of rarefied air is usually confined to the exterior of the body. For this purpose it is applied by means of suita¬ ble receptacles for the arms and legs from which Fig:. 217. Pneumatic Cabinet. the air can be partially exhausted. The first impressions produced by the applications of rarefied air, especially when made in the manner last described, are decidedly unpleasant. The same is true to some extent of local applications. Dr. Waldenberg, Professor in the University of Berlin, has devised a portable apparatus by means of which com¬ pressed air may be inhaled. A representation of the apparatus is given in Fig. 218. These various devices are chiefly employed in the treatment of diseases of the chest, although the so-called vacuum Fig:. 218. Apparatus for inhaling Compressed Air. COMPRESSED AND RAREFIED AIR. 683 treatment has a wider range of application and is said to be useful in the treatment of paralysis, defective development of the limbs, and also as a derivative, relieving the brain and nerve centers of conges¬ tion. We have employed vacuum treatment to some extent, and be¬ lieve it to be a useful agent. Figs. 219 and 220 represent the forms of apparatus which are in use at the Sanitarium. From experiments which we have recently made with Waldenberg’s apparatus, represented in Fig. 218, we think it capa¬ ble of producing most excel¬ lent results, especially in chronic bronchitis, asthma, incipient consumption, and other chronic lung affections. It may be used in such a manner as to increase ex¬ halation as well as inhala¬ tion, and thus produce a greatly increased develop¬ ment of the chest. The same apparatus used for compressed air may be em¬ ployed in the inhalation of superoxygenated air, or air which contains more than the usual propor¬ tion of oxygen. Various medicated vapors are also employed by this means. The remedial value of pneumatic treatment is less thoroughly established than almost any other of the remedial agents, on account of the small amount of attention which this agent has received from sci¬ entific investigators. We believe, however, that it is capable of pro¬ ducing excellent results. In a case of chronic emphysema in which we employed the apparatus, causing the patient to breathe into rare¬ fied air, one-fiftieth of the ordinary pressure being removed, the patient was able to exhale 1 60 cubic inches of air after an ordinary respira¬ tion, though he could ordinarily exhale but 40. A consumptive pa¬ tient, a young lady with remarkably narrow chest, who could inhale but 30 cubic inches of air, by a few weeks’ treatment became able to inhale 120 inches. 684 EAT IONA L REMEDIES FOB DISEASE. SUNLIGHT AND INSOLATION, The value of sunlight in the maintenance and restoration of health, although well recognized, is seldom made of practical utility in the treatment of disease. The important relation of sunlight to health is shown in the effect produced upon plants as well as animals by depriv¬ ing them of its influence. In caves, mines, and other places excluded from the light, plants do not grow, or, at most, they attain only a sickly development. The same is true of animals. In the deep val¬ leys among the Alps of Switzerland, the sun shines only a few hours each day. In consequence, the inhabitants suffer terribly from scrof¬ ula and other diseases indicative of poor nutrition. The women, al¬ most without exception, are deformed by huge goiters, which hang pendant from their necks unless suspended by a sling. A considera¬ ble portion of the males are idiots. Higher up on the sides of the mountains, the inhabitants are remarkably hardy, and are well devel¬ oped, physically and mentally. The only difference in their modes of life is the greater amount of sunshine higher up the mountain side. When the poor unfortunates below are carried up the mountain, they rapidly improve. The value of sunlight for the sick has been amply demonstrated by hospital experience, which shows a much larger percentage of re¬ coveries in rooms abundantly exposed to the sun than in those ex¬ cluded from its rays. That the sun has a powerful influence upon the skin is shown by the great increase of pigment, referred to ordinarily as “ tan,” which is produced by free exposure to the sun and air. This results from an increased activity of the cutaneous tissue. The sun-bath, or insolation, consists in exposing either the whole or a part of the body to the direct rays of the sun, or protected by a single covering of thin white muslin. In taking the bath the head should be protected from the rays of the sun, as the effects upon the head are ordinarily so powerful as to excite unpleasant sensations. In warm weather the bath may be taken in any inclosed space the top of which is open, admitting the sun in such a manner as to allow it to fall upon a person lying upon a bed or couch within it. Such an ar¬ rangement may be easily made of sheets of muslin in the back yard or upon the roof of flat-roofed houses. Ordinarily, however, it is best to have a room constructed in the attic for the purpose, a window being placed in a roof having a south slope in such a way as to make the THE SUN-BATH. 685 sunlight admitted available for three or four hours during the middle of the day. Means should be provided for ventilation, as otherwise the heat within such a room may become too great for comfort and so excessive as to interfere wTith the efficiency of the treatment. All the benefits to be derived from the use of the sun-bath can be obtained from ordinary glass. During the “ blue-glass mania ” a few years ago, we made a number of experiments with the blue glass, by which we were thoroughly convinced that the only difference in the effects of different-colored glass, aside from the mental effect upon sensitive pa¬ tients, is in the modification of the intensity of the rays of light pro¬ duced by the different kinds of glass. The length of time the patient should remain in the bath depends on the condition of the patient and the effect desired. Highly sensitive patients, especially when first beginning to use the bath, should remain exposed to the rays of the sun but a short time, ten to twenty minutes usually being long enough. Less sensitive patients, and those who are accustomed to the effects of sunlight, may remain in the bath for from half an hour to an hour. The bath should be concluded by a tepid sponge bath or wet-hand rub, as the activity of the skin is greatly in¬ creased by exposure to the sun, the patient often perspiring very freely. The effect of the bath is usually to produce a feeling of languor and las¬ situde. Many patients fall asleep while in it. Unpleasant effects are rarely produced. In cases where they occur, the usual cause is too long continuance of the bath or too great intensity of the sun’s rays. To guard against unpleasant effects from the latter cause, it is well to cover the patient at the first of the bath with a sheet, or to draw over the sash through which the light is admitted a screen of very thin material, as gauze or musquito netting. It should be recollected that the solar rays sometimes produce very powerful effects, as seen in sun-stroke, and hence patients should receive careful attention while in the bath, espe¬ cially if they are known to be very sensitive, or easily affected by the sun. Cold water should also be kept at hand for wetting the head in case headache is produced, and also for ready use to guard against sun¬ stroke. By the use of different-colored screens the intensity of the sun’s rays may be modified at pleasure. The sun-bath is an excellent means of treatment in all cases of defective nutrition, in convalescence from various acute diseases, in nervous affections and skin diseases, and espe¬ cially in consumption and dyspepsia. For the last two diseases we have used it very extensively and with excellent success. Consumptives €86 RATIONAL REMEDIES FOR DISEASE. under the stimulating influence of the sun’s rays, gain flesh, improve in appetite, are relieved of their exhausting night-sweats, gain color, and, in fact, improve in every respect. The dry, inactive, almost lifeless skin of the dyspeptic becomes moist and supple, and shows marked increase of activity. Rheumatic patients also are benefited by this bath. In fact, nearly all classes of invalids may employ it with advantage. It has been found also that wounds heal much more rapidly when exposed to the sun’s rays two or three times a day than when kept continually covered. Use of the Concentrated Solar Rays. — A solar ray consists of heat rays as well as rays of light. It also contains actinic or chemical rays, and its therapeutic effects are doubtless due to the combined influence of these three potent forces. By means of a lens all of these rays may be concentrated, and their potency thereby increased, as illustrated by the well-known properties of the burning-glass. The rays of the sun con¬ centrated by means of a lens have been used in the treatment of obsti¬ nate ulcers, discolorations of the skin, and various morbid growths. Undoubtedly, the remedial power of the sun’s rays used in this way would be, upon thorough study and utilization, found to be of very great value in a large number of cases. Ancient Use of the Sun-Bath. — There are numerous evidences that the sun-bath was not only known among the ancients, but was employed by them to a considerable extent. Plutarch tells us that Di¬ ogenes, the renowned Athenian cynic, was, in his old age, accustomed to lie in the sunshine for the purpose of recruiting his energies, — a custom which, according to Pliny, was common among old men in Greece. It is stated that Diogenes valued his sun-bath so highly that when called upon by Alexander, who offered to render him any service in his power, he replied in answer to his kind offer, “ Only stand a little out of my sunshine.” According to Pliny, the custom of the sun-bath wras com¬ mon among the Romans. Indeed, both the older and the younger Pliny were accustomed to spend an hour in exposure to the sun daily after dinner. Hippocrates prescribed the sun-bath for chills. Numer¬ ous other evidences might be cited of the ancient use of the sun-bath, but these will perhaps be sufficient. A French physician once said to some people who had brought their children to him for treatment, “Take these children to the country; feed them as well as you can; but, above all, roast them, — roast them in the sun.” APPLICATIONS OF ELECTRICITY. 687 ELECTRICITY, Probably, next to water, no single remedial agent fulfills so many re¬ quirements in the treatment of disease as different forms of electricity. It is one of the most powerful agents in nature, for evil as well as good it is true, but, nevertheless, it is capable of being controlled so perfectly as to be made useful in the treatment of a large number and great di¬ versity of conditions. Electricity can be applied in such a manner as to produce its most beneficial results only by a person who is familiar with the physical properties of electricity and the principles and mode of con¬ struction of batteries. In order to be able to apply it, it is necessary, in addition, to understand well the structure and functions of the various parts of the body, particularly of the nervous system, and also to be well acquainted with the effects of electricity upon each of the several por¬ tions of the body in health. To become possessed of this knowledge re¬ quires long study and experience. We have not space in this volume, in which so many different subjects are considered, to attempt anything like a thorough treatise upon the nature and medical uses of this powerful agent. All we shall attempt to do will be to point out some of the principal modes of appli¬ cation, aud mention a few diseases and morbid conditions to which it is especially applicable. We are led to do this particularly as we have many .times been requested by patients who have been benefited by the use of electricity under our care, to give them instruction in its employment, so that they might continue its use after returning to their homes, and retain the benefit which they had received. While we do not, in general, recommend the self-application of electricity, yet the re¬ quest referred to has come many times from persons whose intelligence and quickness of perception, together with their personal experience in the application of the remedy, from having been some time under treat¬ ment, rendered them entirely competent, with the proper instruction, to continue at least in the particular mode of application which had been found most beneficial in their particular cases. The principal kinds of electricity to be employed are known as the galvanic and the faradic current. Galvanic electricity as used in medicine is produced by chemical reactions taking place in a battery composed of several cells. The strength of the current depends on the size of the cells, and the number employed. Faradic electricity is produced by passing the current from a very 683 RATIONAL REMEDIES FOR DISEASE. weak galvanic battery consisting of one or two cells through a coil of wire arranged around an iron bar. By this simple device the intensity of the current is very greatly increased. By using several coils, one out' side of the other, a very high degree of intensity can be produced from a very weak galvanic current. The faradic current, although inferior for some purposes, is much more generally useful than the galvanic. Fig. 221 represents a con¬ venient form of faradic battery Fig. 222 is a small battery made on the same plan, for family use. Tig1. 221. Faradic Battery RULES FOR THE USE AND CARE OF A FARADIC BATTERY. The following directions for the use and care of this battery we copy from Beard and Rockwell’s excellent work on medical and sur¬ gical electricity; the same directions will apply in general to most other faradic machines “ To Prepare the Apparatus for Use. — Fill the glass jar with a so¬ lution of water and sulphuric acid, — one part sulphuric acid to eight or twelve parts water. It is not necessary to be rigidly mathematical in regard to the quantity of the sulphuric acid. The average proportion TIIE FAR A DIC BATTERY. G8Q is one-tenth, but it may range between one-sixth and one-sixteenth. The jar should be about two-thirds tilled with the solution. “ It is also necessary to put about a teaspoonful of quicksilver into the cup. This touches the lower end of the zincs and keeps them con¬ stantly amalgamated. “ The quicksilver should not be allowed to touch the central plate of platinum, as it may injure it. In some of the modifications of this apparatus it is necessary to close the prongs between one of the brass posts that is labeled and the one in the middle that has no label. “ The apparatus is now ready for action If the spring does not at once vibrate, give it a slight stroke with the finger. If it still re- fuses to vibrate, it may be necessary to re¬ adjust the screw. If the spring vibrates irreg¬ ularly or too slowly, the evil may usually be remedied by re-adjusting the screw “ Now connect the strings attached to the electrodes with the lettered posts. A is al¬ ways the positive pole, and B, C, and D are al¬ ways negative relatively to A. “To Distinguish the Poles. — It is always possible to distinguish the negative pole by holding the electrodes for a moment in the two hands ; the one in which the current is strongest felt is the negative pole. “ If the apparatus refuses to go, or if it stops at any time while in use, the cause may be looked for — “ 1. In the screw of tlte rheotome , or current-breaker. This may not be properly adjusted. The point may be too far from the spring, or too closely pressed upon it. This want of proper adjustment of the screw is the most frequent cause of a stopping of the machine, and of the refusal of the spring to vibrate. The spring may sometimes be corroded at the point where the screw touches it. “2. In the connection of the w ires. The wires that unite the zincs and platinum may not be properly screwed at their point of connec¬ tion, or may be corroded, or may be broken in their course. “ 3. In the battery itself. The battery — that is, the zincs and plat¬ inum, with the solution in the glass jar — may get out of order in four ways. First, the solution may lose its strength. This difficulty may be remedied either by pouring in some sulphuric acid or by making an entirely new solution, or by simply adding more water. Secondly, 44 Figr. 222. Family Faradic Battery. 690 RATIONAL REMEDIES EOR DISEASE. the zincs may become so corroded and incrusted as to become incapa¬ ble of generating a current. When the zincs have lost their amalgam, local action may take place ; this will be indicated by rapid evolution of hydrogen. Thirdly , a portion of the mercury may have fallen onto the platinum, and corroded it. When this happens, little or no current can be obtained. When we have reason to suspect that such is the case we should clean them with an old tooth-brush or cloth, or amal¬ gamate them. Fourthly, the platinum and the zincs will, in time, by hard and long usage, wear out, and will need to be replenished. “ 4. In the helix. It is very rarely indeed that the helix of this apparatus ever becomes so injured as to be incapable of service. If, after we have properly adjusted the screw and spring, made sure of the connections of the wires, replenished the solution, and cleaned the zincs, the apparatus persistently refuses to go, we have reason to suspect that something may be wrong with the wires that compose the helix. If such be the case, the evil can be remedied only by the inventor him¬ self, or, at least, by some one practically familiar with the construc¬ tion of helices. But we should try very patiently and perseveringly before we accept the conclusion that the helix is thus out of order, for it is an accident of extremely rare occurrence. “ When no current is felt at the electrodes, although the apparatus acts properly, we know that the connection is broken somewhere in the insulated connecting wires. Sometimes the union of the wires with the electrodes is imperfect, and occasionally the wire in some part is broken. Finally, the electrodes themselves may become very much corroded and may need cleaning before a good current can be ob¬ tained. “ To Take Care of the Apparatus. — When not in use, the element •can be taken out of the solution. When the tip battery is used, all that is necessary is to merely turn over the jar. If the element remains too long a time in the jar, an incrustation of salt will sometimes accumu¬ late on the top of the zincs, which will need to be brushed or washed off. This salt is the sulphate of zinc, resulting from the action of the sulphuric acid on the zinc. “ W e may know that action is taking place in the battery when bubbles of hydrogen are rising up by the side of the zinc. “ Methods of Modifying the Current.— The strength of the cur¬ rent of this machine may be modified in several ways, as follows : — “1. It may be modified by withdrawing or pushing in the metallic tube that covers the helix. CONDUCTING-WIRES AND ELECTRODES. 691 “ When this tube covers the helix, an indefinite number of branch currents are induced in it that interfere with the main current and weaken it. In proportion as this is withdrawn, the induction of branch currents, and the consequent interference with the main cur¬ rent, grows less. “ This method of modifying the strength of the current must he used continually both in general and localized faradization. “ 2. The current may be modified by increasing the quantity of the solution, or of the sulphuric acid in it. This measure can be resorted to when the current fails to accomplish our purpose, even when the metallic tube is entirely or nearly withdrawn. “ 3. When the current passes through the body of the operator, the current may be modified by increasing or diminishing the pressure of the hand on the sponge connected with the positive pole. “The direction of the current can be changed at any time, by re¬ versing the position of the electrodes, or by reversing the conducting wires in the posts.” Conducting-Wires. — These are usually composed of several twisted or braided copper wires covered with silk. When the battery is used very much, the silk frequently becomes worn so much that the wire is easily broken. On this account it is well to pass the wire through a small rubber tube, which will act as a protection without doing it any injury. One advantage is that the wire will be kept dry, so that it will not communicate electricity to the hand or other parts of the body of the patient or operator which it may fall upon, as it may do when uncovered. Electrodes. — In addition to the cojDper plate to which reference has already been made, which is applied to the feet, several sheets of cop¬ per of different sizes and shapes may be used for lengthy applications to different parts of the body. One, for instance, a plate the size of the hand, may be used for application to the back or to the pit of the stom¬ ach. The same plate or a larger one may be used for application to the abdomen. Electrodes of all shapes and sizes can be obtained of the manufacturers of batteries. Metal electrodes should never be ap¬ plied directly to the skin ; a covering of cloth or a sponge moistened in water should always intervene. Some electricians use salt water for moistening the electrodes, as it is a better conductor of electricity than ordinary water. The metal electrodes should frequently be scoured, as the electric current causes rapid corrosion to take place. I hey should be kept bright and clean. Care should also be taken to thoroughly 692 RATIONAL REMEDIES FOR DISEASE. cleanse the cloth and sponge covers by boiling and thoroughly wash¬ ing in a solution of soda or chlorinate of soda. O Fig. 223. Galvanic Battery. Fig:. 224, Galvano-Cautery Battery. A galvanic battery is shown in Fig. 223 which represents the form manufactured by the Galvano-Faradic Co., of New York. This bat¬ tery we have employed for a number of years with entire satisfaction, and can recommend it to any one needing a bat¬ tery of this sort. It is much more difficult to care for and requires much more experience in its use than the fara- dic battery, and hence is not well adapted to use by persons who have not had special training for the purpose. On this account we shall give no description of the mode of using or caring for the machine. Fig. 224 represents the battery which is used for galvano-cautery in the removal of tumors and other morbid growths. It is of course useful only in skilled hands. Figs. 225 to 230 represent some of the different instruments used in the application of electricity to various parts of the body. The Effects of Electricity. — Probably no other agent has so powerful an effect upon the human system as electricity. Its general influence is to increase vital activity. Just how this is accomplished U not known. Its close resemblance to what is known as nerve force, GENERAL FARADIZATION. 6°3 lias led some to believe that nerve force and electricity are identical, but numerous facts and experiments show that this cannot be true. It does not act as a stimulant, however, as there is no reaction from its proper use. Its effect seems to be that of a corrector of the vital actions. An organ which is acting too slowly will be quickened by it to increased activity : while one that is in a state of morbid activity, under the influence of electricity may be restored to its normal func- tions. It acts directly upon the several tissues of the body through Fig:. 230. which it is made to pass, and also through the medium of the nervous system. It is probable that its principal effects are produced in the latter manner. We have not space to describe its effects upon the body in health, upon which its remedial applications are based, and will content ourselves with a brief description of the principal modes of applying faradic electricity, and some of the principal diseases to which it is applicable. General Faradization. — In making this application, place the patient on an ordinary stool with his face toward the battery and his feet on a sheet of copper to which the conducting cord connected with the negative pole is attached. Patients who through paralysis or for any other reason are unable to sit up, may receive the treatment while lying in a bed or on a lounge, the sheet of copper being sup¬ ported against the feet by means of a pillow or cushion. Except in cases where there is a special indication of the application of elec- ti’icity to the lower limbs, the negative pole may be applied to the lower end of the spine instead of the feet. This plan is a better one with infants, with whom difficulty may be experienced in keeping the feet 694 RATIONAL REMEDIES FOR DISEASE. upon a metallic plate. The right hand of the operator should be placed upon the forehead of the patient, while with the left he touches the sponge of the positive pole of the battery. The sponge should not be grasped at first, but simply touched with the tip of one finger. Then, if the patient does not feel the current as desired, it may be taken in the hand and pressed with sufficient firmness to obtain as This jilan is better than the application of the sponge directly to the head, as by this means the operator can deter¬ mine with exactness the strength of the current which is applied, and can modify it to the condition or feelings of the patient in the most delicate de¬ gree. Especial care should be taken in applying elec¬ tricity to the head, as it is one of the most sensitive parts of the whole body on account of the large num¬ ber of nerves which it con¬ tains and the very close proximity to the bones of the skull. After a few seconds, pass the hand to the top of the head, first wetting the hair, as otherwise the current would not be communicated to the bodv, on account of the poor conducting qualities of the hair. The top of the head at the point where phrenologists locate the organ of firmness, is an im¬ portant point, as the application of electricity here has a powerful effect upon the whole nervous system. Some patients, however, are so extremely sensitive about the head, that they will not bear even the mildest application. In such, the application should begin with the back part of the head, which, to¬ gether with the upper part of the spinal cord, will usually bear quite strong applications. This, too, is an important point, as very marked effects upon the whole system may be produced by application sim- much strength of current as is needed. O GENERAL FARADIZATION. 695 ply to the back and sides of the neck. This is doubtless due to the large number of nerve trunks which pass from the brain through this region to other parts of the body. The sympathetic and gan¬ glionic systems also lie near the surface in this region, and hence are easily affected by the application of electricity here. Although the hand is usually much more agreeable than the sponge as a means of applying electricity, the latter may be used on all parts of the body except the head. In using it, the handle is taken in the right hand and the sponge touched lightly to the patient at first, the pressure be¬ ing increased as the strength of the current is ascertained. After holding the sponge at the back of the neck for one or two minutes, it should be moved down the side of the neck on each side. Next ex¬ tend the application to the spine by slowly moving the sponge toward the back of the neck down to the lower end of the spine. Then gently remove it and return to the head, repeating the application. After eight or ten applications of this kind, the sponge may be applied on either side of the spine below the border of the scapula. It should not, however, be applied over the scapula, as the application will be of little benefit and will usually produce pain or unpleasant sensations. Special pains should be taken to apply the sponge over the region of the kidneys, spleen, and liver, and the lower part of the back. The application should next be made to the chest and abdomen. In applying it to the chest, place the sponge at the borders of the front part of the chest and move it toward the sternum, following as closely as possible the course of the ribs. This is an excellent means of developing the muscles of the chest. In applying to the abdomen, the sponge should be held stationary over the pit of the stomach, or the central portion of the abdomen may be manipulated with a sort of kneading movement. Complete faradization includes applications to the extremities also, although this is not always necessary. The application to these parts consists simply in passing the sponge over the muscles, using sufficient strength of current and pressure of the sponge to cause a slight contraction of the muscles. The chief bene¬ ficial effects of general faradization upon the nervous system may be obtained by application of the poles to the feet and head, only apply¬ ing the positive pole to the upper part of the neck or back part of the head, and retaining it in that position for ten or twenty minutes. This application usually produces very pleasant tonic effects. It should not be applied so strongly as to cause contraction of the muscles of the neck. RATIONAL REMEDIES FOR DISEASE. Local Faradization. — In this mode of using electricity, the cur¬ rent is applied only to some limited area of the body. This is chiefly used for local diseases, although local applications to the neck and spine affect the whole body, as well as those particular parts. The proper rule to be followed in making local applications is to use care, as a general thing, to keep the positive pole nearest the head. Local faradization has a wide range of application in the treatment of dis¬ eases. As its effects cannot be separated with great distinctness from those of general faradization, we will consider the two together, first calling attention to a few rules which should always be observed in the application of electricity. 1. Use the mildest currents with which the effect desired can be obtained. No benefit and much harm may be caused by the use of too strong currents. Special care should be taken in the case of sen¬ sitive and nervous patients, especially at the outset. 2. Avoid passing the hand or sponge over portions of the body where the bones come near the surface, as the scapula, the skull- bones, the sternum, the elbows, the patellae, the prominences about the hips and ribs, and other places where the bones are scarcely covered with flesh. The pains produced when electricity is applied to these parts, often cause serious irritation and alarm to patients who are unaccustomed to the use of electricity, and are likely to discourage them from continuing its employment. 3. Applications should at first be very short, and it should be re¬ garded as a general rule, with few exceptions, that short applications frequently repeated are much more effective than long ones at greater intervals. From five to twenty minutes is usually sufficiently long for an application in any ordinary case. 4. No attention should be paid to the slight muscular soreness which often follows the first two or three applications of electricity, as these will speedily pass away as the patient becomes accustomed to the use of this agent. The same may be said of the increased nerv¬ ousness and irritability sometimes noticed in patients beginning the use of electricity. 5. It is also specially important that the patient’s nervous system should be in a quiet condition during the application. If his interest and confidence are fully secured, its effects will generally be much more marked than if the contrary is the case. This fact is true with reference to nearly all remedial agents, but more especially of electric¬ ity than of any other. THE ELECTRIC BATH. 697 Electricity is applicable — and more usually with success — to nearly all the curable diseases to which the human system is subject. It may also be used in incurable cases for the purpose of palliating symp¬ toms which cannot be wholly relieved. For this purpose it is one of the most successful remedies known. It is especially applicable in cases of obscure nervous disorders in which a diagnosis cannot be made out with absolute certainty, as in these cases it proves of value more frequently than any other agent, and if intelligently applied will certainly do some good and can do no harm. Excellent results may be expected from the use of electricity in diseases due to or associated with general debility of the vital functions, impairment of nutrition, such as dyspepsia, neurasthenia, or “ nerve-tire,” nervous debility, anemia, hypochondriasis, hysteria, chronic rheumatism, paralysis, chorea, some forms of skin disease, epilepsy, and various light affec¬ tions. In the forms of disease mentioned, general faradization should be used. Local faradization is indicated in all diseases which are dependent on a local cause, which include some forms of local paralysis, most cases of neuralgia, sprain, and other local injuries, diseases of the eye and ear, and disease of the larynx and lungs. Local applications are also exceedingly useful in painful affections of the stomach and bow¬ els, and particularly in neuralgia of the abdomen and pelvic organs, and local affections of the reproductive organs. Local applications are also frequently used in combination with general faradization to in¬ crease local effects, as in special application to the joints in chronic rheumatism, and to the stomach in nervous dyspepsia. The Electric Bath. — Electricity may be combined with water and other agents in a variety of ways. The simplest form of electric bath may be applied in connection with the foot and sitz bath by placing in the foot bath the negative pole and applying the positive pole as directed for general faradization, keeping the sponge very wet, so that a sponge bath is really administered to the patient at the same time with the electric current. The form of general faradization last mentioned in the description of that mode of applying electricity, is especially adapted to the sitz bath, as the positive pole may consist of a large wet sponge placed in such a position that the patient can rest the back of his head upon it. Application made in this way for ten or fifteen minutes, or during the usual time of the bath, constitutes a very excellent form 698 RATIONAL REMEDIES FOR DISEASE. of treatment for nervous patients. By employing plates, which can be held in position by tapes or bands, the positive pole may be applied to the stomach, abdomen, loins, or spine, in cases requiring such local application. A better form of the electric bath, when general effects are desired, may be administered in an ordinary wooden full-bath tub. The cop¬ per or zinc plates may be placed at each end of the bath, with which the positive and negative poles of the battery may be connected, — the positive to the head, the negative to the foot. The back of the pa¬ tient should be supported while in the tub by a sloping board of the width of the tub, and having in the center a slit four or five inches in width, so as to allow the passage of the electric current through the body. A still better plan is to place under the back of the head and neck a large sponge with which the positive pole may be connected as in the sitz bath, and the negative pole may be connected with the body by means of a sponge electrode used on the patient in essentially the same manner as directed for general faradization. Both methods are, however, rather crude, and only very imperfect results can be obtained from such forms of bath. To administer the bath successfully, secur¬ ing the best results, a bath apparatus is necessary. It consists of a wooden tub with a false bottom made so as to support the upper part of the head while in the bath. No part of the body comes in contact with the electrodes, as the water is a sufficiently good con¬ ductor of electricity to communicate the current to the body. At the head of the bath is placed an elaborate electrical apparatus consisting of a helix, in which the galvanic current is converted into faradic elec¬ tricity, and a switch-board, which bears a number of nickel-plated knobs connected with the interior of the apparatus by means of which the electric current can be controlled at pleasure. One knob starts the apparatus by connecting the battery with it ; another connects the electric current with the electrodes of the tub. By means of another the current can be instantly reversed at pleasure. Twelve other knobs are used for bringing into connection any two of the twelve different electrodes connected with the bath. By means of this elab¬ orate apparatus it is possible to pass the electric current through any part of the body of the patient while lying in the water, or to pass divided currents in all directions through the body at the same time. The length of the bath should not be more than from five to fifteen minutes, and should be carefully adapted to the condition of the patient. ELECTRO- VAPOR BA TIL 099 The water of the bath should be of the same temperature as for the full bath. Salt and other mineral substances are frequently added to the water, but their principal effect is to increase its conducting power. The administration of this bath requires a skilled operator, as the electric current connected with it is so powerful that much harm might be done by a blunder on the part of the person administering the bath. It is, however, under such complete control that in the hands of a skilled attendant it can be adapted to the sensibilities of the most del¬ icate patient. This form of administering electricity is frequently well borne when the remedy can be used in no other way. This bath is useful in nearly all cases in which general faradization is indicated. It is only contra-indicated by great emaciation and want of power to react after the application of water. In these cases, however, by beginning with general faradization, the patient’s condi¬ tion may in many cases be so improved as to admit of the application of the bath. In cases of this kind, it is well to apply an inunc¬ tion with the bath to secure a thorough activity of the skin and pre¬ vent taking cold. Most persons experience much stronger tonic effects after the application of the electric bath than after general faradiza¬ tion applied in the usual way. In a very extensive use of this bath for a number of years we have come to consider it the most powerful and useful tonic available in the treatment of various forms of nervous prostration and debility. This bath has also been shown to be es¬ pecially useful in eliminating from the system metallic substances, such as lead and mercury. It has been stated by scientific authorities that lead can sometimes be discovered in the water of the bath after its application to a person suffering with lead-poisoning. We have never verified this statement by actual experiment, but the fact that every application of electricity is accompanied by electrolysis, or the decom¬ posing effect of the electric current, certainly gives grounds for the supposition that such an effect might be produced. We are positive of having seen most excellent results follow the administration of the bath in such cases, at any rate. Electro- Yapor Hath. — This is a combination of general faradiza¬ tion with the ordinary vapor bath. It may be administered by means of a faradic battery in connection with any one of the different methods of applying the vapor bath, in all of which it will be found usually effective. It is most conveniently applied in connection with a vapor box, or with a battery and apparatus constructed es- 700 RATIONAL REMEDIES FOR DISEASE. pecially for the purpose. It should he mentioned, however, that no electricity is communicated to the body through the vapor, as has been claimed by numerous charlatans who have employed the bath in va¬ rious forms. Vapor is not a conductor of either galvanic or faraclic electricity, and hence cannot be the means of communicating it to the body. We have taken pains to test in a thorough manner with the galvanometer electro-vapor baths in which it was claimed that the vapor was electrified, and have always found the claim to be false. This bath should be applied in cases in which both the vapor bath and general faradization are indicated. The advantages of the com¬ bination are that by means of electricity the relaxing effects of the vapor bath are counteracted by the tonic effects of electricity, so that the patient can endure longer and more frequently-repeated use of the powerful eliminative effects of the vapor bath than without the use of electricity. We have never been able to observe any specific effects from the bath, although we have for several years made daily use of it in a large number of cases. Thermo-Electric Bath. — This bath is a combination of faradic electricity with hot air. It may be administered by means of a faradic battery in connection with the ordinary hot-air bath, or by the appli¬ cation of general faradization during the exposure to hot air in the Turkish bath. The effects of electricity in combination with hot air are similar to those obtained by its use in connection with the vapor bath. We have found it particularly useful in the treatment of chronic rheumatism, as the application of electricity to the painful joints greatly enhances the soothing effects of the bath. In some cases we have secured relief in this way when all other means had failed. We have devised and had constructed for the administration of this bath at the Sanitarium an apparatus, the form of which is essen¬ tially as follows : It is a double- walled cabinet, having windows which slide upward upon two sides, and a door upon one side. It is lined throughout with zinc, with the exception of the bottom ; this is composed of slats placed about one-lialf inch apart, underneath which is a coil of steam-pipe which is connected with the steam heating apparatus in the building. In the front part of the apparatus is placed a stool so constructed as to be raised or lowered at pleasure while the patient is seated upon it. In front of the stool is a foot-rest, upon which is placed a plate used as the nega¬ tive electrode. Another electrode is placed upon the stool, and still THERMO-ELECTRIC BATH , 701 others are so arranged as to be connected with various parts of the body at the will of the operator. A folding cover resting against the back side of the apparatus may be brought forward, and in connec¬ tion with an adjustable part just inside the door, behind the patient when he is seated upon the stool, the lower part of the cabinet may be divided from the upper part so that the hot air will be applied only to portions of the body below the head. By sliding up the windows, the patient may thus have pure air to breathe while taking the bath. If the effect of the Turkish bath is required, the folding cover can be thrown back and the windows brought down so that the whole body will be immersed in the hot air. No unpleasant effects are felt from the confinement as provision is made for sufficient ventilation to keep the air pure. During its application, the electric current can be passed at will in different directions through various parts of the body by means of a very convenient switch -board placed outside the appa¬ ratus and under the entire control of the attendant. By means of a perforated steam-pipe led into the bottom of - the cabinet beneath the false bottom, steam can be led into it, thus securing a vapor or Rus- sian bath instead of the hot-air or Turkish. At the conclusion of the bath, by means of valves also placed outside of the cabinet, either a shower bath or spray bath may be administered without exposing the patient to the cool air, the temperature of the water being accurately graduated by means of a device for the purpose which enables the at¬ tendant to ascertain the temperature of the water before it reaches the patient. The above -described apparatus we have found to be the most useful for bath purposes of any with which we have ever become ac¬ quainted, as by its use we are able to administer so large a variety of baths, hot-air, Turkish, vapor, Russian, thermo-electric, electro-vapor, spray, shower, and electric baths being all given with equal facility and efficacy. We have examined the bath lately introduced into several of our large cities which is called the thermo-electric bath, but which produces no such effects as are claimed for it. The electricity for this bath is gen¬ erated by the alternate heating and cooling of a set of zinc and copper plates in the bottom of the cabinet. It is claimed by the inventors and those by whom it is employed that the whole cabinet is filled with the electricity thus generated ; but from a careful examination of the bath we have become satisfied that the amount of electricity thus gen¬ erated is so small as to be inappreciable in its effects, and we have 702 RATIONAL REMEDIES FOR DISEASE. shown beyond all possible question that the claims of its advocates are in the highest degree absurd and unreliable. It is stated, for instance, that through the action of thermo-electricity a diffuse perspiration will be produced at 90°, and that a higher temperature than this is never required in the bath on account of the potent effects of the “ combined influence ” of “ heat, electricity, and oxygen ” ! In a personal test of the bath we found that moisture appeared upon the body at a lower temperature than 90°, but this was wholly attributable to the con¬ densation of moisture produced by the contact of water from the shower with the hot plates in the bottom of the cabinet. The head, which was not confined in the bath, did not perspire in the slightest degree, and real perspiration did not begin until the temperature was raised and maintained for some time at 105°. The thermometer of the attendant very conveniently showed 92°, but a self-registering thermometer which we took with us into the bath showed at its con¬ clusion the temperature stated. We cannot resist the conclusion that this much-vaunted bath, when scientifically considered, is something of a humbug, since it does not accomplish what is claimed for it. We believe that all the effects produced by it are attributable to the hot air employed in connection with it. It is certainly an excellent hot¬ air bath, but that is all that can be said in its favor, except, perhaps, that it may have considerable potency in affecting the imagination of the patient. The bath previously described is vastly superior to it in every particular, as the electric current produced in connection with it is a sensible one and can be increased or diminished, as the necessities of the case require. Various Combinations of Electricity with Water.— Electricity may be combined with water in a variety of other ways. The electric pour is a very simple and efficient combination. It may be conven¬ iently administered by connecting the negative pole with some part of the patient’s body, as the feet, and the positive with a tin dipper. When the water is poured through the dipper upon any part of the body, the circuit will be completed and the patient will feel its effects. This is an excellent application to painful or swollen joints. It is also a favorite way of concluding the electric bath, the pour being administered to the back of the neck and to the spine. By the use of a metal nozzle or a cop¬ per wire with a coil at one end placed in the rubber tube, the hose douche may also be converted into an electric douche and advantageously used in the treatment of enlarged glands, hypertrophy and congestion of the / SURGICAL USES OF ELECTRICITY. 70:} liver and spleen, as well as for the other purposes for which the douche is applicable. Electricity used in this way in connection with the uter¬ ine douche is a very effective means of increasing the utility of that very valuable remedial agent. In fact, we consider this method the best of all for applying electricity to the uterus, as it is far less irritating than the contact of a metal electrode. Electricity may also be applied to the nose in the nasal douche in the same way, care being taken to keep the glass nozzle dry. It may be applied to the ear and eye by the same means. It is possible also to administer electricity through the medium of the spray, but the effects thus obtained are very slight. We have fre¬ quently combined electricity with the foot bath, cold compress, hot fomentations, and even packs, with excellent results. Other Electrical Appliances. — It has been found that two metals of whatever character, as zinc and copper or silver, when placed in con¬ tact with the skin, generate a slight current of electricity on account of the action of the perspiration upon the zinc. The quantity of electricity produced in this manner, however, is exceedingly small, and, consequently, it is very doubtful whether appliances of this sort can be made of any practical value in the treatment of disease. Quacks, however, have made great capital out of this mode of applying electricity, and have con¬ ducted a large business in this as well as in other countries in the man¬ ufacture of galvanic belts and various other appliances of the same sort, which are recommended to be worn by persons suffering from all forms of disease, these appliances being held out as a panacea for all the ills to which human flesh is heir. We have met many persons who had worn these belts for months without an appreciable effect. We have no hesitation in pronouncing them utterly worthless for most of the pur¬ poses for which they are recommended, and so slightly beneficial in any case as to be of little or no value as remedial agents. Sill •gical Uses of Electricity. — Electricity has come to be con¬ sidered as one of the most useful of surgical appliances. By means of numerous ingenious devices which arc now furnished with the batteries for use in surgery, it is possible to perform almost any operation which can be performed by all other surgical appliances combined, if we ex¬ cept the various forms of .splints and braces used in the treatment of deformities, although many of these may be replaced by some form of electric appliance. Through the well-known heating effects of elec- tricitv, parts may be rapidly and almost painlessly destroyed, the opera¬ tion being known as electro-cauterv. We have frequently employed O v 704 RATIONAL REMEDIES FOR DISEASE. this method in the removal of polypi, tumors, and other morbid growths which could not have been otherwise treated without great risk and even considerable danger to the patient. By means of electrolysis, or the decomposing power of electricity, nevi, aneurisms, cancers, and nu¬ merous other morbid growths and conditions, may be removed. Elec¬ trolysis furnishes the best known means of depilation, or removal of the hair, the method of which is fully described under the proper heading. MEDICAL GYMNASTICS, OR SWEDISH MOVEMENTS, The value of exercises of various sorts as a remedial measure has for ages been recognized by both barbarous and civilized nations. The Chinese, one of the oldest nations on the globe, together with the inhabitants of India, have long appreciated the value of exercise. Ac¬ cording to accounts which have been gathered from their writings, they have for the last two thousand years or more possessed a knowl¬ edge of the remedial value of exercise, and have employed it fre¬ quently in a more or less systematic manner. The ancient Greeks and Romans also employed exercises of various sorts, not only for devel¬ oping the body, but for relieving many diseased conditions. We might find it interesting to note more particularly some of the peculiar modes of treatment employed by the various nations men¬ tioned in ancient and modern times ; but as our space is limited, we will confine our remarks entirely to what are known at the present time as “ Swedish Movements.” This system of medical gymnastics was chiefly developed by a Swede by the name of Ling, who was born about the middle of the last century. His system of exercise was put in practice in Stockholm, Sweden, about the year 1813. The results obtained were so remarkable and attracted such general atten¬ tion that Ling very soon secured the cooperation of the Swedish Government, which enabled him to found an institution under gov¬ ernmental patronage for the employment of his system for the treat¬ ment of chronic diseases of various sorts, which was so successful that it remains in existence to the present time, though its founder has been dead for more than forty years. At the present time many hun¬ dred patients are annually treated at this institution, and its success has encouraged the establishment of similar institutions in various parts, especially in this country, so that it is probable that at. the present time there are not less than fifty in active operation. TO REGULATE THE CIRCULATION. 705 THE REMEDIAL VALUE OF MOVEMENTS. The value of movements in the treatment of disease has become now so thoroughly established that it is not necessary for us to ad¬ duce other arguments than the results of their use to show their utility. For some years after the introduction of this mode of treatment, it was looked upon with suspicion by the better class of physicians gen¬ erally, and was left to be employed by quacks and charlatans. In many instances it has been employed by unscrupulous persons who sought to attract patronage by laying claim to the possession of skill¬ ful magnetic powers. There have been many cases in which patients were benefited by the treatment of these quacks, when in fact their success was wholly due to the results of the manipulations of various sorts which were invariably employed by the so-called “ magnetic doctors.” We will now briefly consider some of the principal remedial effects of the employment of medical gymnastics. 1. To Regulate the Circulation. — It has long been recognized as an established physiological fact that the circulation of the blood is greatly influenced by the action of the muscles. By muscular ac¬ tion the blood is pressed along the veins, and thus its progress toward the heart is greatly accelerated. Whenever there is a deficiency of muscular activity, as in persons who are confined to their beds or who are unable to take a sufficient amount of daily exercise, the em¬ ployment of Swedish movements will often produce most marvelous results in restoring to a normal condition the unbalanced circulation. They are of special service as a derivative measure when applied to the hands and feet of any person suffering with habitual coldness of these * members. We are acquainted with no remedy which will so readily secure marked and permanent results in this direction as this. Ap¬ plied to the whole skin, it is an excellent means of relieving conges¬ tion of the head, spine, liver, and other organs. 2. To Increase Secretion and Excretion. — Movements are of very great service in cases in which there is very giteat diminution of secretion and excretion. They are especially useful in cases of torpid¬ ity of the liver and inactivity of the skin, 3. To Increase Respiratory Power. — No function may be so rapidly augmented and permanently increased by the aid of move¬ ments as that of respiration. We have known patients to double their 45 706 RATIONAL REMEDIES FOR DISEASE. breathing capacity by a few weeks’ practice in the employment of lung gymnastics. 4. To Increase Digestive Power. — In the great majority of chronic diseases of other organs, as well as in functional derangement of the stomach, deficient muscular power and activity of the stomach and intestinal canal is one of the principal morbid conditions, and one to which especial attention must be given in directing a successful mode of treatment. In many cases, movements applied to the abdo¬ men seem to meet these indications better than any other remedy which can be employed. We have been in the habit of prescribing this means of treatment in cases of this sort for a number of years, and are more and more thoroughly satisfied with the results obtained. 5. To Increase Assimilation. — In not a small proportion of cases of chronic disease which come under the care of a physician, defective assimilation is one of the most serious obstacles which must be over¬ come in conducting the case toward a successful issue. It is not what a person eats, or even what he digests, that benefits him, but what he assimilates. There is no means by which assimilation may be so pow¬ erfully stimulated and encouraged as by the careful and skillful em¬ ployment of Swedish movements. This fact is now so thoroughly recognized by the leading physicians of all countries that this means of treatment is relied upon as almost the sole remedy in the treatment of a large class of cases. 6. To Increase Yital Action. — The influence of movements in in¬ creasing vital action is shown not only by the rapidity with which pa¬ tients gain in flesh under their employment, but by the fact that the immediate effect of the application in the majority of cases is to produce marked rises of temperature which cannot be accounted for in any other way but that there has been a marked increase in vital action as a result of treatment. As the effect clearly suggests, the remedy is of great service in the treatment of cases of general debility and all other diseases in which there is general inactivity of the vital functions. 7. To Regulate Muscular Action. — No remedy is of greater value in the treatment of that class of cases in which there is disordered muscular activity, as in various distortions of the spine, which result from unequal muscular action, in the great majority of cases of dis¬ placement of the womb, and various other diseases peculiar to women. DESCRIPTION OF VARIOUS MOVEMENTS. 707 In cases of paralysis no other remedy, unless it be electricity, will ac¬ complish so much as this, and if we were obliged to dispense with the' use of one of these two remedies we should certainly choose this as the one of greatest value. General Principles Governing the Application of Movements* — In the application of medical gymnastics it is important to give at¬ tention to the following points : — 1. The kind of movements to be taken should be carefully and ac¬ curately adapted to the condition of the patient. 2. If the movements to be taken are of such a character that the patient can administer them to himself, he should receive careful in¬ struction, as everything depends upon the proper application of the means employed ; if they be given by another person, the attendant should be thoroughly trained, as much more harm than good will be done by an unskillful application of the remedy. 3. Movements are best administered at about ten o’clock in the forenoon, or between three and four o’clock in the afternoon, unless there is some special reason wThy they should be administered at some other time, as in cases of slow digestion. 4. At the beginning of a course of treatment with movements, the first application should be gentle, so as to avoid the production of muscular soreness and nervous irritability, which will often appear when this precaution is disregarded. In case, however, the patient suffers with a slight soreness, or with an increase of nervous irritabil¬ ity, and other slightly unpleasant symptoms, his fears should be at once quieted by the assurance that both these symptoms will disappear in a few days, as they will be almost certain to do. 5. In the application of movements, care should always be taken not to extend them sufficiently long to induce great fatigue. The pa¬ tient should always be made to take an hour or two of rest after the application. Description of Various Movements. — The various movements employed are divided into three general classes : Active, Passive, and Half-Active, or Active-Passive. In the first class of movements the exercise is obtained wholly from the individual effort of the patient ; in the second, the exercise is applied by means of an attendant ; in the third class there is a combination of the two, attendant and patient, cooperating, the two acting either alternately or at the same time,. 708 RATIONAL REMEDIES FOR DISEASE. each gently resisting the other’s efforts. In institutions in which this remedy is relied upon almost entirely it is common to give a great va¬ riety of movements of various sorts. We will not attempt to describe the whole list, but will give a brief description of a few of those which we have found the most useful, and which can be the most readily utilized. Movements to Develop the Muscles of the Trunk. — Figs. 232- 245 represent movements which are especially designed to develop the muscles of the back, chest, and abdomen. an exercise to be taken in a door¬ posts of proper height. The po- vell shown in the cut. The ex- lg one foot and placing it for- at the same time throwing the Fig\ 234. body forward with energy. The forward motion being arrested sud¬ denly by the arms, a strong strain is brought upon the muscles of the front of the body, particularly those of the chest. After the for¬ ward movement, the foot is returned to its place beside the other. This movement is repeated eight or ten times with each foot. As in all other movements, the action should be deliberate, and energy and considerable muscular strength should be employed. This is a most excellent means for strengthening the chest. Fig. 233. Another admirable movement for developing the chest and the muscles of the trunk. The feet are thrown apart to brace the body, the hands being clasped over the head, and the trunk is oscillated from Fig. 232 represents way, or between two sition is sufficiently v e-rcise consists in raisir ward as in walking, ; / TRUNK DEVELOPMENT. 700 side to side several times in succession ; then the same movement is ex¬ ecuted from before backward. Fig. 234. The weight of the body is partly sustained by the hand holding the top of a bed-post, or a ring fastened in a wall or post. The movement consists in swinging the body, making the points of support of the hands and feet the centers of motion. The movement may be varied by allowing the body to fall slowly toward the hands by bending the arms at the elbows, and then straightening the arms to restore the body to the first position again. The effect is to expand the chest and strengthen the muscles of the abdomen and back. Fig. 235. The body is placed in the kneeling posture, with a cushion under the knees, and the heels prevented from rising when the body Fig. 235. Fig. 236. Fig. 237. bends forward, as shown by the dotted line, by being placed under the edge of a sofa or some other convenient object. This movement affects not only the trunk but also the muscles of the calf and thigh. Fig. 236. The patient stands against a wall or post, and bends forward as far as possible with¬ out bending the knees. By the aid of an as¬ sistant, the head may be readily lowered to a level with the knees. Fig. 237. In this movement the patient’s head is thrown back as far as possible, and to prevent the patient from falling backward, the head is supported by the wall or a post. Fig. 238 represents essentially the same move¬ ment, its effect being intensified by bending the body backward nearly to a right angle. In tak- Fig. 233. 710 RATIONAL REMEDIES FOR DISEASE. ing this movement it is necessary to have the hack supported by the hand of an assistant. Fig. 239. A movement calculated to increase the strength of the mus¬ cles of the back. The trunk is kept perfectly rigid, while the body is maintained in position for a few seconds, or until the muscles begin to show signs of fatigue. Fig. 240. The body is supported by the toes, which rest upon the floor, and the hands are placed upon a stool o r platform raised about a foot higher than the floor. o The effect of the move¬ ment is to increase the volume of the chest by throwing it forward. Fig. 241. This movement is some¬ what similar to the preceding, but its ac¬ tion is different, the tension being brought o o chiefly upon the ab¬ dominal muscles. Ex¬ cellent effects are ob¬ tained by its use in cases of prolapsus of the pelvic organs, rec¬ tum, etc. The body should be brought slowly into position, the feet being retained in position for a moment and allowed to fall again. After resting a minute or two the movement should be repeated, until the body has been elevated five or ten times. Fig. 242. In this movement the body is wholly supported by the head and heels, which rest upon platforms raised a few inches from the floor. This movement calls into vigorous action all the muscles of the neck, trunk, and legs. A little assistance will at first be required by TR UNK DEVELOPMENT. 711 the patient in getting into position. The position should be main¬ tained for a few seconds, and then the body may be let down to the floor to rest. After three or four minutes the movement may be re¬ peated. The number of repetitions must depend, of course, entirely upon the strength of the patient. Care should be used not to strain the muscles too violently, which may easily be done in taking this movement, especially by beginners. Fig. 243. The trunk is supported upon a platform in such a way that the lower end of the spine just reaches to the end of the supporting surface. The limbs are held rigidly in the position seen in the cut. This is a powerful means of exercising the muscles of the abdomen and thighs. Fig. 244. In this movement the position is reversed, the legs being supported and held in position upon a platform by an attendant while the trunk is sustained in the air by the muscles of the abdomen and thighs. This movement should be used cautiously at first by those who are unaccustomed to such exercise. Fig. 245. This is a modification of the preceding, in which the 712 RATIONAL REMEDIES FOR DISEASE. trunk is sustained with the face downward. In this movement the principal strain is upon the muscles of the back instead of the abdomen. Miscellaneous Movements. — Fig. 246, which represents toe-stand¬ ing, requires no explanation. It is an excellent means of increasing circulation in the lower extremities. The body should be slowly ele¬ vated into the position shown, the patient rising as high as possible upon the toes while slightly supporting the body by the finger placed against the wall or a post. The elevated position should be maintained as long as possible, and the body slowly lowered to its natural posi¬ tion. The movement, in order to be effective, must be executed very slowly, so as to give time for the desired changes in the blood-vessels. Fig. 247 represents an excellent exercise for the feet. The position of the feet is well shown in the cut. The exercise is produced by bending the knee and throwing the weight upon the forward limb. This movement should also be executed slowly, being repeated ten to twelve times with each foot. Fig. 248 represents a light form of exercise consisting of rotation of the limbs. The limbs may be twisted together, both in the same di¬ rection, or in alternate directions. A very great variety of other movements of a similar character might be given, but many of these are included under the head of gymnastic exercises, which are fully described elsewhere in this work. Passive and Active-Passive Movements. — This class of move¬ ments requires the assistance of a skilled attendant. Many of them PASSIVE AND ACTIVE-PASSIVE MOVEMENTS. TVS may be learned by almost any intelligent person, however, and their great utility warrants a brief description in this connection. Figs. 249 and 250 represent exercise of the arm, flexion and exten¬ sion. These movements, like most other passive movements, are appli- Figr. 251. cable to persons who are either too weak to take active exercise or are suffering from paralysis which renders them incapable of doing so. It is a most useful exercise in cases of rigidity of the joints as the result of fractures, sprains, or other accidents which require long inactivity. It should be employed in all such cases ; and neglect of this impor¬ tant measure in cases requiring it has not infrequently resulted in ir¬ reparable injury to the affected joints. Fig. 251 illustrates flexion and extension of the hand at the wrist; to be used in the same cases as the preceding. Fig. 252 indicates the same kind of exercise applied to the lower extremities. 714 RATIONAL REMEDIES FOR DISEASE. Figs. 253 and 254 represent an attendant in the act of flexing and extending the foot of a paralytic patient. Fig. 255 shows the method of rotating the hand at the wrist, a means of treatment often found useful in cases in which there is deficient mobility of the joint. Fig. 256 illustrates the same movement applied to the foot. Fig. 255. Fig. 257 shows the position of the lower limbs and the hands of the attendant in applying the rotary movement to the hip-joint. Fulling Movement. — Fig. 258 illustrates a form of passive move¬ ment which has been appropriately designated as the “ fulling ” move¬ ment. The cut represents the movement as applied to the arm. It is Fig. 25 6. Fig 257. applied to the head, neck, trunk, and lower limbs in a similar manner. It is an excellent means for encouraging assimilation and relieving in¬ ternal congestion by increasing the circulation of the blood in the sur¬ face of the body. Kneading. — Fig. 259 illustrates a method of kneading the muscles of the arm. The muscles of the arm are grasped at its upper extrem- STROKING. 715 ity by the thumb and finger, being rubbed to and fro between them as the hand passes along the arm. In a similar manner the whole body may be kneaded. Kneading of the bowels applied in a manner similar to that in which a baker kneads bread, employing either one or both hands, is a most excellent means of relieving slow digestion and chronic constipation. Stroking . — Fig. 260 illustrates a movement known as stroking. The hands are applied to the part of the body to which the movement Fig-. 258. Fig. 259. Fig. 260. * is being applied, and are moved slowly from above downward at first, and then afterward in an opposite direction, in such a manner as to fol¬ low the course of the veins and thus encourage the venous circulation. The application may be a very gentle one, soothing in character, or may be sufficiently vigorous to secure a considerable degree of exer¬ cise. Applied to the head and spine, stroking is a very excellent sed¬ ative, often securing sleep in persons who are unable to sleep on ac¬ count of nervousness. Stroking the abdomen is an excellent means of increasing the activity of the bowels, and should be made to follow the course of the colon, so as to encourage the downward passage of the contents of the bowels. The hands should be applied low down on the right side and pressed upward to the ribs, across to the oppo¬ site side, and then downward to a point opposite the place of starting. Either one or both hands may be applied, and the movement may be made as gentle or as vigorous as the condition of the patient or the effect desired may require. At the outset of treatment it will often be found that great tenderness is present, so that the most gentle ma- 716 RATIONAL REMEDIES FOR DISEASE. nipulation must be employed ; but an experienced manipulator will at first avoid the tender points, gradually encroaching upon them more and more, until finally as great a degree of vigor may be employed as is desired. Clapping. — Fig. 261. This movement consists in alternate percus¬ sion of the surface with the palms of the hands. It is one of the most generally applicable of all the forms of movement, being usefully ap¬ plied after nearly all forms of water bath. Whenever it is necessary to excite activity of the surface it is an admirable measure. Its ef¬ fect is evidenced by the red color of the skin which almost invariably follows its application. Chopping. — Fig. 262. This movement is similar to the preceding, the only difference being that the edge of the hand, instead of the palm, is used in application. In both chopping and clapping, it is important that the movement of the hand should be wholly from the wrist, which should be kept perfectly flexible. When the wrists are rigid, the move¬ ment being made from the elbows, the effect produced is unpleasant, the patient feeling as though he were being pounded. In chopping, the blow should be quick and sharp, though little force should be employed. The surface should be struck with the fingers, which should be kept a little way apart, and held loosely, so that they will clap together with each stroke. The object of the movement is to secure by quick, short blows rapid contraction of the muscles. It is a most excellent means of passive exercise, and a most efficient promoter of assimilation. Chop- SAWING AND VIBRATION. 717 ping may be applied to the whole body. It should be executed systematically. Knocking. — This movement consists in gently striking some part of the body with the clenched hand, the force of the blow being received upon the palm of the hand. Fig. 2G3 shows a form of this movement U Fig-. 267. which is known as “ chine knocking.” The patient supports himself with one hand against the wall, and, leaning forward, strikes upon the lower part of the back with the other hand twenty or thirty smart blows. This movement is very effective in removing the dull, aching pain often felt in this region, and exciting activity of the lower bowels. Sawing. — Fig. 264 illustrates this simple movement, which may sometimes be employed with advantage. Its effects are similar to those of stroking, though it is a somewhat more vigorous movement. Yibration. — Fig. 265 illustrates the manner of vibrating the arm. The assistant takes the patient’s arm, holds it out straight, and vi¬ brates it as rapidly as possible for fully a minute. After a minute’s rest the same is repeated, until the vibration has been performed eight or ten times. The lower extremities are vibrated in a similar manner. 718 RATIONAL REMEDIES FOR DISEASE. The vibration of the chest, abdomen, and other parts of the trunk, is performed by placing the palm of the hand upon the part to be exer¬ cised, and by a rapid quivering movement of the muscles of the arm producing the desired effect. Percussion. — Fig. 26G. This exercise consists in striking the sole of the foot, protected by a shoe or boot, with a flat-sided ferule or wooden rod for the purpose. This is an excellent means for warming cold feet, and has been recommended for chilblains. Massage. — This mode of treatment, which is at the present time becoming quite popular, especially in the treatment of cases of nervous debility, anemia, etc., is really nothing more nor less than a combina¬ tion of a number of the above-described forms of treatment. Treat¬ ment generally begins with the feet. The first movement applied is fulling of the skin of the part manipulated, which is followed by kneading. One part of the body after another is manipulated, until the treatment has been applied to the whole body, especial attention being given to the bowels and loins. Vibration, chopping, and strik- MASSAGE. 710 ing are next applied, the treatment concluding with stroking of the head and spine. In many cases in which this^treatment is indicated, there is great tenderness of the spine or intercostal spaces, as in cases of spinal irritation, nervousness, etc. The attendant must take care not to exaggerate the suffering of the patient by rude handling of these parts, but by encroaching gently upon them from day to day gradually accustom them to touch and manipulation, until finally, in Fig-. 270. Fig-. 271. the great majority of cases, the tenderness may be made to wholly disappear. We have often observed cases in which a sensation of acute pain was produced by a very gentle touch, while firm and hard pressure gave no uneasiness whatever. For the class of cases men¬ tioned, together with the majority of cases of chronic dyspepsia ac¬ companied with great debility, consumption, uterine disorders, and, in fact, all diseases characterized by debility, massage is a most valuable mode of treatment. When the skin is dry and rough, and, in fact, in nearly all cases in which massage is indicated, the benefits of treat¬ ment will be greatly increased by the employment in connection with it of light inunction with refined cocoa-nut oil. Canton oil is the best 720 RATIONAL REMEDIES FOR DISEASE. of any sort we have used. The only objection to it is its tendency to become rancid. This difficulty can only be corrected by keeping it in a cool place and covered with lime-water. Muscle-Beating. — This is a method of treatment closely allied to Swedish Movements which has been recently approved and rec¬ ommended by C. Klemm,* a German physician of eminence. The instru¬ ment employed is represented in Fig. 2G7. It consists of three rubber tubes, together with a handle to which they are fastened. Beaters of various sizes are employed to suit the various portions of the body to be treated. Figs. 2G8 to 272 illustrate the vari- ous modes of using this form of ex¬ ercise. In the figures referred to, the patient is represented as administer¬ ing treatment to himself. In the majority of cases, however, it is better that the remedy should be applied by an attendant. The only advantage which this method of treatment has over those described is that it is so simple that it can be applied byalmost any one, and hence requires less skill for its administration, so that it may be applied by the patient himself. It is certainly a most excel¬ lent means for securing an equable circulation in the extremities, and for producing a derivative effect by exciting increased circulation in the external portions of the body. The inventor claims for it results which are seemingly much out of proportion to the simplicity of the apparatus employed. Notwithstanding, we have no doubt that if thoroughly and perseveringly employed a very great amount of good may be accomplished by its use. Lung Gymnastics. — No part of the body is more susceptible of development by judicious and appropriate exercise than the lungs. The amount of air which passes to and fro in the respiratory process is ordinarily but about two-thirds of a pint ; and in cases of disease is much less, often being reduced to less than a third of this amount. * Muscle-Beating ; by C. Klemm. M. L. Holbrook, New York. RELATION OF MIND AND BODY. 721 By the daily exercise of the lungs in such a manner as to develop the chest, the breathing capacity may be very greatly increased. We have frequently seen the chest expanded three or four inches by a course of appropriate training. One of the best exercises for this purpose is forced respiration, which consists in breathing as deeply as possible, making strong efforts to fill the lungs, and emptying them as completely as possible. This exercise should be taken slowly from five to thirty minutes at a time, and should be repeated several times a day. MENTAL THERAPEUTICS, Whatever may be the ultimate relation of the mind to the body, its influence over the latter for good or evil, in disease as well as in health, is certainly too great to be ignored in the consideration of the various agents by which the human system may be affected. Indeed, under some circumstances, the influence of the mind upon the body surpasses that of all other agencies that are or can be brought to bear upon it. Without delaying to furnish evidence for the influence of the mind upon the body in health, as this fact is so well and generally recognized, we will call especial attention to the effect of the mind in producing disease and also as an agent in the successful treatment of various diseases. Medical literature furnishes us with almost innumerable instances in which crave disorders as well as trivial affections have been cured © through the influence of the emotions. Numerous cases have occurred in which apoplexy has resulted from a sudden fit of anger or fear as also from intense pleasurable emotions, as a transition from a state of despair or grief to that of joy. It is. stated that the man who invented the means for applying steam in nav¬ igation died suddenly of apoplexy upon learning that his invention had received favorable notice from a scientific committee to which it had been submitted. A mother fell in an apoplectic seizure upon meeting her daughter, for whom she was waiting at a railroad depot, but who she had reason to fear had been killed in an accident which had just occurred. History informs us that an ancient Grecian died of excessive joy from receiving his three sons returning crowned as victors in the Olympic games. Insanity has not infrequently resulted from intense mental em'otion, both pleasurable and the opposite. It is, however, well recognized that fear, grief, and other depressing agents, are far more apt to produce serious results than are those of a pleasurable character. It may not seem so remarkable that diseases of the nervous system 46 722 EAT ION AL REMEDIES FOR DISEASE. should be produced in this manner, but instances are not wanting to show that mental influence may produce disease of almost every func¬ tion throughout the body. The phenomenon known as bloody sweating, which has by many been considered impossible, has been observed in several instances, in which the exciting cause was extreme rage or fear. For example, the case is reported of a sailor who was so affected by fright during a storm which threatened destruction to the ship and all on board, that he fell speech¬ less on the deck and broke out into a profuse perspiration of blood. When wiped away from his forehead it appeared again, oozing out from the skin like ordinary perspiration. Microscopical examination of the sweat in other cases has shown that it does not contain blood corpuscles but only the coloring matter of the blood. It seems that this phenom¬ enon occurs also in animals. A case is related of a hippopotamus, which, under confinement, manifested for hours the most intense rage. The whole skin became covered with a bloody perspiration. In this case a microscopical examination showed that blood corpuscles had actually ex¬ uded from the skin. Several cases are recorded in which jaundice has been produced by rage and fear. Medical students sometimes become very yellow in con¬ sequence of mental anxiety which they undergo in the suspense preced¬ ing examination when failure is feared. The effect of fear in- causing cholera during an epidemic of this dis¬ ease is so well known that it scarcely requires mention. Instances of this sort have been so numerous that there can be no doubt that during cholera times many persons have died of symptoms exactly resembling those of the disease, of which fear was the only cause. A case is recorded in which small-pox, or a case exactly resembling it, seems to have been produced by the same mental influence. It is .-stated that a woman who was begging, with her child, in an English •city, stopped a carriage containing two ladies, requesting alms, which being refused, she threw her child into the carriage declaring that it had the small-pox and would communicate it to the inmates, upon whom she showered the most horrible imprecations. There was no evi¬ dence that could be obtained that the child was suffering with disease of any sort, yet one of the ladies was taken with small-pox within twenty-four hours, and died. Chorea, or St. Vitus dance, hysteria, and other convulsive and hys¬ terical diseases, arc frequently produced from the influence of the imagi- MENTAL THERAPEUTICS. 723 nation, often as the effect of example. This fact has been observed in a number of instances in which diseases of this sort have actually be¬ come epidemic wholly through imitation. The effect of grief and disap¬ pointment in producing serious organic diseases, as consumption, is a fact too well known to need confirmation by examples. Every one is familiar with cases in which persons suffering some kind of disappoint¬ ment, or great bereavement, have gone into a decline, and died in a few months in spite of all that could be done for them. Both rheumatism and gout have been produced by mental influence, either through severe fright, the agony of suspense, or from fixing the mind oil a part of the body, as in the case of John Hunter, who is said to have produced gout in his great toe by the prolonged effort of the will. We might multiply to any extent instances in which diseases have been produced by the influence of the mind upon the body, but we will now call attention to some of the morbid conditions, of the cure of which through mental influence alone there have been well-authenti¬ cated instances. Everybody is familiar with the fact that toothache frequently disappears as the sufferer from this painful affection ap¬ proaches the dentist’s office. Numerous instances have occurred in which persons have visited the office of a dentist for the purpose of pro¬ curing an extraction, but have found themselves so wholly free from pain when they reached the office door that they returned home without suffering the loss of the offending member. Many years ago an Italian physician was very successful in treating toothache by having the pa¬ tient rub an insect between the fingers and apply them to the aching- tooth. He claimed to cure at least three-fourths of his patients by this means, in which the imagination was the only active agent. Cases of painful joints in which patients have suffered, .sometimes for many weeks, months, or even years, with gout or rheumatism, or purely hys¬ terical affections, have not infrequently been cured by the operation of some strong mental influence, as sudden fright from the burning of a house, the sudden approach of a mad-dog, or from some other cause. The case is related of a patient who, while suffering from an attack of colic, received a prescription, with instructions to “take it.’ He obeyed the order literally, taking the paper prescription instead of the compound, the making of which it directed. The medicine had such a magical effect that in a few hours he was entirely cured. It is said that the physicians in Tartary very frequently treat their patients in this way, writing the name of the medicine on a piece of paper, rolling it 724 RATIONAL REMEDIES FOR DISEASE. into a ball, and allowing the patient to swallow it whenever the drug which they desire to administer is not at hand. An English physician relates a case in which a lady patient of his, suffering with pain in the chest, or pleurodynia, was promptly relieved in a somewhat similar manner. He wrote a prescription for a plaster and handed it to her, giving directions to wear it, meaning, of course, the plaster. She, sup¬ posing that the paper prescription was the remedy intended to be worn, placed it over the painful part, with the effect of producing prompt relief. Hysteria and other convulsive diseases, and even epilepsy, have been cured by severe fright, intense grief, and by affecting the imagination. The French committee appointed to investigate the claims of Mesmer, the first magnetic doctor, when he was exhibiting in Paris in the latter part of the last century, stated in their report that in their Experiments they had succeeded both in causing and curing convulsive affections through the influence of the imagination. o o Almost every one is familiar with anecdotes concerning persons who have for years been bed-ridden with paralysis or other diseases, render¬ ing them unable to walk, who have been suddenly cured by severe fright, as from a sudden fire or other danger. Sir Humphrey Davy had a case of paralysis which was entirely cured by the application of a thermometer to the patient’s mouth. In taking the temperature of the patient prior to an administration of nitrous- oxide gas, he observed that the patient seemed to experience beneficial results. Indeed, the patient was quite enthusiastic over the effects of the new remedy, which was applied daily without the use of any other means, with the result of wholly curing the patient in a week, although he had been for some time affected with the disease. Herodotus tells the story of the sudden cure of a dumb person in the presence of great danger. He states that “ during the storming of Sar¬ dis, a Persian, meeting Croesus, was, through ignorance of his person, about to kill him. The king, overwhelmed by this calamity, took no care to avoid the blow, or escape death ; but his dumb son, when he saw the violent designs of the Persian, overcome with astonishment and ter¬ ror, exclaimed aloud, ‘ O man, do not kill Croesus ! ’ ” It is stated that the cure thus effected was permanent. Probably the most familiar and indeed one of the most remarkable, of all illustrations of the influence of the mind in effecting a cure of disease, is seen in the familiar method of removing warts by charms of MENTAL THERAPEUTICS. 725 various sorts. Plenty of instances might be cited in which persons having warts which had existed for years and had been treated by more tangible means without success, have had them quickly removed by the application of some such remedy as rubbing with a split bean, doing the bean up in paper and leaving it out in the road for some one to pick up ; or rubbing them with a piece of fresh meat stolen from the butcher-shop, and then .throwing the meat away to decay, the wart being supposed to disappear with the decay of the meat. It is impossible to believe that in these cases the remedies employed can have any curative effect whatever. Whatever influence they may have must be attributed wholly to the imagination of the person em¬ ploying them. That warts are often cured in this way, however, there can be no doubt, as hundreds of the most intelligent people are ready to testify. An interesting illustration of the effect of the imagination in curing disease, occurred in the siege of Beda in 1G25, when large numbers of the soldiers were suffering extremely with the scurvy. The Prince of Orange announced that he would provide an invaluable remedy. Each physician was supplied with two or three small vials of balsam, a drop or two of which was stated to be sufficient to impart powerful medicinal properties to clear water. With this diluted med¬ icine the soldiers were treated, and with a success which was most ex¬ traordinary, and which was wholly due, of course, to its effect on the imagination. Gout has been promptly cured by fear. Abernetliy says on this point in his lectures, “ You may see a person with gout that is almost unable to move with pain ; but produce a shock to the nervous system by telling him that the house is on fire and he will scamper about like a lamp-lighter.” Ague has in innumerable instances been cured through the opera¬ tion of the imagination of the patient. In this disease, as we shall elsewhere show, all that is necessary for a cure is to interrupt the reg¬ ular paroxysms of the disease. We have known instances in which persons were cured by such novel remedies as going down stairs head¬ foremost on all-fours, and other procedures incapable of producing any other than a mental effect. Without doubt, a large share of the re¬ sults obtained in the use of quack remedies arise from the faith of the patient in the remedy employed. There are numerous illustrations of the employment with great success of remedies which are inert or nearly so, and which attain great celebrity until their inert properties 726 RATIONAL REMEDIES FOR DISEASE. are discovered. Remedies of this sort are well represented by Hol¬ man’s Liver Pad, Galvanic Belts, the much lauded waters of many mineral springs, etc. The cures effected by “ magnetic doctors ” offer plenty of illustrations of the power of the mind — that of the patient, not of the doctor — over the body. As we have elsewhere shown, there is no probability whatever of the existence of any occult force which can be communicated from one person to another, as is claimed by believers in animal magnetism. All the results which have ever been obtained by this mode of treating disease may be fairly attrib¬ uted to the influence of the will and the imagination of the patient himself. The effects obtained from the so-called “ magnetic rubbing ” must be attributed, in part at least, to the effects of rubbing, independ¬ ent of the patient’s imagination. We have elsewhere in this work (see page 149) called attention to a series of observations which we made some years ago on the effect of the mind upon the body in the cure of diseases. We have since observed many more striking in¬ stances in which equally appreciable results have been obtained in the same way. IMPORTANCE OF EMPLOYING MENTAL THERAPEUTICS. We believe that mental therapeutics is a perfectly legitimate agent for use in the treatment of disease, and there is no reason why intelli¬ gent physicians should not employ it in the treatment of many disor¬ ders, at least those of a functional character. Every observing physi¬ cian is aware of the different results which occur according as the pa¬ tient’s mental condition is cheerful or depressed. It is the common experience of all physicians to see patients decline and die under the influence of maladies which might and should have been relieved by the remedial agents employed, but the beneficial effects of which were counteracted by the unhappy mental state of the patient. If the pa¬ tient’s mind can be brought into full harmony with the method of treatment employed and his faith and confidence fully secured, his chanced for recovery from any malady are increased tenfold. Many times have we seen patients to whom we could give no encouragement and whose recovery seemed to be wholly impossible, gradually im¬ prove under simple methods of treatment, and finally recover, as we firmly believe, more through the influence of their own hope and de¬ termination to recover than through any remedial agent applied. On the other hand, we have with equal frequency seen patients whose dis- MEDICAL DIETETICS. 727 orders were not of a serious character and who had sufficient natural vigor and sufficiently favorable conditions to secure recovery, appar¬ ently, at least, but who went down into the grave, as we have every reason to believe, simply because of a lack of force of character or of strength of will to bring the mind to co-operate with the treatment employed or to preserve such a mental state as would be conducive to recovery. Every physician, and, in fact, every person who has any¬ thing to do with the sick, should realize the importance of imparting courage, good cheer, and hope to them, as by that means they may in many cases do more than in any other way to secure their recovery. There are, no doubt, cases in which it is allowable for the physician to> bring to bear such means as fear and other powerful mental agents in the treatment. These cases must be rare-, and such means when resorted to should be used with the greatest caution, like doses of powerful poi¬ son. A mental remedy which may be used, however, with much success in many cases is the directing of the patient’s attention to the part under treatment, at the same time inspiring the most perfect confidence that the cure will certainly be effected. It has been shown by numer¬ ous experiments that concentrating the attention upon any part induces changes in its circulation and nervous supply, and that attention can thus be used as a means of curing the disease. In using it as a cura- tive measure it is of course essential, as before remarked, that the pa¬ tient should be thoroughly convinced that the result desired will cer¬ tainly be secured by the means employed. In a large share of cases, at least, the expected result will be obtained, although the remedy em¬ ployed may he wholly inert. The remarkable effects often obtained by the use of highly potentized remedies must be attributed to this- cause. In conclusion, we again urge that physicians pay more attention to the employment of mental therapeutics. We do not doubt that if remedies were more often applied to the mind and much less to the stomach, the practice of medicine would be attended with much more- successful results. MEDICAL DIETETICS, We have already called attention, in considering the hygiene of food, to the important relations of food to the maintenance of health and the prevention of disease, but another phase of the subject of dietetics of almost equal importance still remains for consideration 728 RATIONAL REMEDIES FOR DISEASE. namely, the relation of food to the system in a state of disease. It has long been known that the use of various articles of food produces dif¬ ferent effects upon the system in disease from their use in health, many food substances which are taken apparently without detriment in health becoming causes of serious difficulty when taken while the sys¬ tem is suffering with disease. In consequence of this fact, intelligent physicians in all ages have taken care to interdict special articles of food in certain diseases, in which they had been found to produce a pernicious effect. It has also been observed that certain articles of food when received into the system while it is suffering under the morbid influence of special diseases, seem to exercise a favorable in¬ fluence upon the progress of the disease, hastening recovery or miti¬ gating symptoms, if not exerting a still more powerful remedial influ¬ ence on the disease. This has given rise to what has been termed the “ diet cure,” sometimes also called the “ nutritive cure,” different phases of which are known as the “ milk cure,” the “ whey cure,” the “ butter¬ milk cure,” the “ grape cure,” the “ starvation cure,” and similar terms. While it is not probable that in any of the so-called diet-cures the article of food upon which chief reliance is placed fills so impor¬ tant a part by any means in the cure of the disease to which it is said to be adapted as has been supposed, it is, nevertheless, probable that in most cases, at least, the use of the particular article recom¬ mended is to secure more favorable conditions for the curative opera¬ tions of the vital force than might otherwise have existed. This may be attributed either to the superior virtues of the food employed, or, as is in most cases undoubtedly true, to the . absence of articles of a damaging character. The object of this section is to call attention to the relations of articles of food to diseased conditions, pointing out particularly the morbid conditions and diseases in which some partic¬ ular articles of food are inadmissible, and also the conditions in which the same articles are specially indicated. First, we will notice — Meat, or Flesli-Food. — As has been shown elsewhere, meat in the condition in which it is almost always eaten contains a large propor¬ tion of excrementitious or waste products, which exist in the tissues of animals at the moment of death. Poisonous substances are ordi¬ narily eliminated from the system with sufficient readiness to prevent any immediate serious effects ; but when the system is laboring under disease, the ability to dispose of this surplus of waste and poisonous matter is so greatly lessened that much harm may result from its use. MEAT, OB FLESH-FOOD. 720 This is especially true in cases in which the liver and kidneys, — two of the most important eliminative organs, — are affected, as in Bright’s disease, acute albuminaria, scarlatina, diphtheria, incontinence of urine, inflammation of the liver, gall-stones, and diabetes insipidis ; and in general diseases, accompanied by fever of any degree of intensity, as typhoid fever, scarlatina, diphtheria, malarial fevers, measles, small¬ pox, and other febrile diseases, including acute and chronic rheuma¬ tism, gout, pleurisy, pneumonia, and pericarditis ; together with diar¬ rhea, dysentery, and the other bowel-diseases incident to warm weather, including cholera ; various forms of nervous disease, particularly those which occur in sedentary people, insomnia, or sleeplessness, some forms of neuralgia, chorea, epilepsy, and some disorders of the stomach, as in chronic gastritis, weak digestion, accompanied with tenderness at the pit of the stomach, and that form of dyspepsia usually termed bilious¬ ness, or bilious attacks. Persons who have suffered from apoplexy, especially when the attack has been recent, and those suffering with valvular disease of the heart, require an unstimulating diet, and hence the less animal food taken the better, although it need not be wholly interdicted, except in recent cases of apoplexy. Both of these dis¬ eases require that the amount of animal food used should be exceed¬ ingly limited. In the treatment of drunkenness, it is important to bear in mind that the stimulating influence of meat has the effect to excite the desire for alcohol, and hence its use should be very limited if allowed at all. Mr. Napier, of England, has recently shown that one of the best means, of destroying the appetite is to cause the drunkard to abstain from the use of flesh-food ; and our own experience in the treatment of in¬ ebriates has abundantly confirmed the same observations. Children often suffer much with nervousness and other obscure troubles which may be directly traced to the use of flesh-food. When allowed at all, it should never be taken until the teeth are sufficiently well developed to allow of its thorough mastication. In nearly all of the diseases mentioned in the preceding paragraphs it is of tlie greatest importance that the use of meat should be interdicted, at least while the patient is under treatment and foi a sufficient length of time after the cure has been effected to preclude the possibility of its having any influence to cause a recurrence of the disorder. In many cases this would require abstinence from meat for a long time, and in a majority of cases this would be found beneficial 730 RATIONAL REMEDIES FOR DISEASE. rather than otherwise. It has been frequently observed that patients who have been cured of rheumatism while abstaining from the use of animal food have an almost immediate relapse, with swelling of the joints, and high fever, upon resuming the use of animal food. Re¬ lapses of typhoid fever are often similarly caused by the use of meat before the stomach has acquired power to digest it. Inflammation of the stomach is often produced in fever-patients during convalescence by the use of meat. It should he recollected that in withdrawing meat a sufficient quantity of some other form of nitrogenous food should be supplied. Oatmeal and wheat-meal furnish the required elements in a form in which they can be easily assimilated, and never produce any of the serious results which follow the use of meat, in the diseases and conditions named. In most cases, also, milk and eggs may be used to a considerable extent, especially the first-mentioned article, either by itself or in combination with such farinaceous foods as oatmeal gruel, barley gruel, rice, and farina. Meat may often be used with very great benefit, sometimes as an almost exclusive article of diet for a short time, in cases of great de¬ bility, anemia, farinaceous or flatulent dyspepsia, and acid dyspepsia. The special reason for its use in debility is, that, on account of the readiness with which it is digested, the nitrogenous tissues which are suffering for need of repair may be more rapidly built up than by vegetable food ; the system also requires a larger proportion of nitrog¬ enous elements than is found in a natural state. If in any of these cases, however, the use of meat is contra-indicated on account of other conditions, its place may be supplied by such food as gluten flour which contains a large proportion of nitrogenous elements, but a very small share of the carbonaceous. Meat is particularly useful in the forms of dyspepsia mentioned on account of its being digested in the stomach and not undergoing fermentation, and thus giving rise to acidity. It is quite the custom nowadays to use the meat in these cases in a raw state, a practice of which we cannot approve, however, as it exposes the patient to the liability of contracting diseases more serious than those he possesses. Reference has already been made to the fact recently demonstrated by Dr. Leidy, of Philadelphia, that tape¬ worm in America is most frequently derived from beef which has been eaten in a raw or slightly cooked state. In any case in which it seems necessary to administer meat in a raw condition, it should be inspected with the greatest care to insure its absolute freedom from parasitical FATS AND MILK. 731 infection. If small white specks are observed, it should be at once discarded. It is, however, often difficult to detect the embryos of the tape-worm in beef by the unaided eye, and hence absolute safety would require the inspection of every portion of the meat with the microscope. Fats. — These are of all articles the most difficult to digest. A piece of fat pork will remain in the stomach five or six times as long as a ripe apple, and two or three times as long as a portion of rice or well-cooked grain. When fats are added to food in cooking, it becomes much more difficult of digestion. Fried food, pie-crust, and similar articles are ab¬ solutely indigestible by a weak stomach. Fat also interferes with the digestion of other food, as we have previously shown, and also diminishes the secretion of bile by producing an inactive and congested state of the liver. On this account, fat meats and the different fats should be wholly interdicted in most cases of dyspepsia, torpid condition of the liver, gall¬ stones, jaundice, and in that somewhat indefinable but very common condition known as biliousness. For all these reasons, they should be forbidden in obesity also. Fat in the form of cream, and such nuts as almonds, chestnuts, and filberts, may be used freely with benefit by very thin people whose di¬ gestion is not greatly impaired, and especially in the emaciation incident to consumption, diabetes, and other wasting diseases. In many of these eases, the use of a small quantity of cream in connection with other food seems to have a favorable influence upon nutrition by increasing the assimilation. Milk. — Milk is one of the few articles of food which contains all the elements of nutrition in a form easily digested and assimilated; hence it is rarely to be forbidden altogether. However, there are many persons whose experience seems to show that it has a clogging effect upon the liver, at least in particular cases, occasioning headache, “ biliousness,” and other unpleasant symptoms. Such, of course, should avoid its use. There are also certain classes of dyspepsia, such as acid and bilious dys¬ pepsia, which do not tolerate the use of milk. Many persons will find, however, that they are able to use milk without any inconvenience, if it is taken in the proper manner, being eaten rather than drank, and taken in limited quantities. Such persons should avoid the use of sugar and fruits, especially acid fruits, in conjunction with milk. Milk must be forbidden in cases of gall-stones and j aundice. Milk is sometimes found almost indispensable as an article of food in 732 RATIONAL REMEDIES FOR DISEASE. the treatment of fevers, especially in the cases of children, in the treat¬ ment of certain classes of nervous disease, particularly those dependent on defective nutrition and accompanied with impaired digestion. The free use of milk in some cases as an almost exclusive article of diet, has been found to be very advantageous. We have frequently succeeded in cur¬ ing cases of this sort by a milk diet in conjunction with other hygienic measures, after all other known remedies had failed. The use of skim- milk is an excellent means of combating obesity. Yegetables. — Vegetables are objectionable in some diseases and morbid conditions, first, on account of the large amount of woody matter which they contain, which renders them difficult of digestion and liable to produce irritation of the membranes in different parts of the aliment¬ ary canal ; second, on account of the large proportion of starch which most of them contain in the form which is more difficult of digestion than the starch grains, and is hence more liable to undergo fermenta¬ tion, developing injurious acids and troublesome gases. The diseases and morbid conditions in which vegetables should be wholly interdicted, or restricted to a very small amount, are as follows: — Painful and flatulent dyspepsia, also in many cases of acid dyspepsia, gastric ulcer, cancer of the stomach, dilatation of the stomach, and pain¬ ful hiccough. Vegetables containing a large proportion of starch must also be interdicted in diabetes. Bright’s disease requires that the patient should abstain* from the use of asparagus, turnips, cabbage, carrots, beans, peas, and all other vegetables which contain a large amount of woody fibre. In very obstinate and long-standing torpidity of the liver it is wise for the patient to refrain for some time from the use of coarse and starchy vegetables as potatoes, also from grains composed chiefly of starch, as rice and starchy preparations, such as sago, farina, etc. In a large share of the diseased conditions of the stomach it is nec¬ essary for the patient to abstain from the use of vegetables in conjunc¬ tion with fruits or meats. They may be taken alone or with grains when they may not be tolerated with other classes of food. Tomatoes, ordinarily wholesome, are thought to be injurious in dia¬ betes incipitis, and asparagus is by many physicians interdicted in rheu¬ matism; asparagus and beans are also to be abstained from in this disease when they produce pain in the region of the kidneys with de¬ posit in the urine. The free use of vegetables is especially indicated in constipation of the bowels, in scurvy, and in many cases in which patients have for a long time been deprived of them. GRAINS AND FRUITS. 733 Grains. — Grains when properly prepared are almost always well received by the system in disease as well as in health. About the only condition in which they may not be taken is diabetes melitis, in which they are objectionable on account of the large proportion of starch which they contain. Even in this disease, however, grains deprived of their starchy constituents are among the most essential articles of food. There are also conditions of the digestive organs which do not admit of any but the finer portions of the grains, as in painful dyspepsia and gastric ulcer. It is also of the greatest importance in these cases that food should be very thoroughly cooked. The free use of grains is especially indicated in neurasthenia, nervous debility, anemia, consumption, and constipation. The object of their use in these cases is twofold: first, to supply an abundance of nitrogenous elements and nutritive salts in a condition in which they can be easily assimilated, as in consumption and all diseases characterized by exhaus¬ tion of the nervous system ; second, to supply the necessary degree of bulk in the digestive organs, and enable the stomach and bowels to per¬ form their functions properly, as in constipation, a very frequent cause of which is the use of too concentrated food. Fruits. — Fruits afford a very small proportion of nutriment and yet are very useful in various diseased conditions as additions to other foods. About the only conditions in which their use must be in¬ terdicted are acid and flatulent dyspepsia, and sweet fruits in diabetes. Fruits, especially apples and lemons, are particularly useful as curatives of biliousness and constipation. The use of grapes in typhoid fever has been very highly extolled; to such an extent, in fact, that in some places this disease has been treated by what was termed the grape cure, which consists in confining the patient almost exclusively to the use of grapes. Grapes have also been used in relieving other diseases. The idea that fruit should not be used in bowel diseases is an unfortunate error, as many people have been led to abstain from the use of this wholesome article of food in cholera times, and during the “ heated term,” when bowel diseases are most common. There is plenty of evidence to show any one that good ripe fruit is one of the most efficacious preventives of bowel diseases of all kinds, and that the use of such fruits as grapes, without the seeds, ripe apples, and the other better kinds of fruit, is of value as a means of curing some forms of bowel trouble. Many fruits, particularly apples, and those fruits containing a considerable proportion of water, seem to increase the activity of the kidneys, and hence are use¬ ful when those organs are functionally inactive. 734 RATIONAL REMEDIES FOR DISEASE. Sugar. — There are no conditions of the system for which sugar is to he especially recommended, since it is always eaten in abundance in the form of starch, which, it is well known, is wholly converted into sugar in the system, and in case of an insufficient supply from other sources, the liver will rapidly produce it, even from the nitrog¬ enous constituents of the food. There are, however, numerous condi¬ tions in which its use is very injurious and should be wholly inter¬ dicted. Some of the more important of these are diabetes, gall-stones, acid and flatulent dyspepsia, and also inactivity of the liver, and that very common morbid condition known as biliousness. Salt. — As previously pointed out, the dietetic value of salt is by no means so thoroughly established as many seem to suppose. What¬ ever may be its relation to the system in health, there is the best of evidence to show that in some diseases, at least, its use should be re¬ stricted as much as possible, and in some cases discontinued altogether. This is particularly true of gout and inflammation of the kidneys. Persons who are liable to attacks of gout, often find themselves en¬ tirely free from their painful enemy when abstaining wholly from salt, but suffer a relapse immediately when chloride of sodium or any other of the sodium salts is taken into the system. Very little salt should be taken in fevers ; the former custom was to interdict its use altogether. It is probable, however, that with persons accustomed to its use, a small quantity may be advantageous in preventing the ap¬ petite from failing altogether, especially when the fever is prolonged. It is evident, however, that when the eliminative organs are so greatly overtaxed as they always are during a febrile attack, very little of this or of any other element which will increase their labor should be taken. To restrict the use of salt is almost as useful in rheumatism as in gout. In diabetes, when the tendency of the patient is always to drink more water than is best for him, and when the blood is al¬ ready rendered too thick or of too high specific gravity by the excess¬ ive quantities of sugar in it, a limited use of salt is evidently indi¬ cated. Condiments.— After what has been said of the use of condiments in health, we need scarcely add that their use should be wholly inter¬ dicted in disease. They are responsible for a large number of diseases, and there is no diseased condition which is not increased by their employment. ABSTINENCE FROM FOOD. i So Drinks. — The regular amount of fluid received into the system is a very important matter in many diseases. In some forms of dyspepsia the use of dry food and almost total abstinence from drinks, especially near the time of meals, is absolutely essential to recovery. This is em¬ phatically true of the particular kind of dyspepsia in which, on account of the inactivity of the absorbent vessels of the stomach and intestines, fluids are taken up slowly and remain for a long time near the alimen¬ tary canal. This condition has sometimes been called the “ indigestibil¬ ity of fluids.” We have also confirmed an observation made by an em¬ inent English physician, that in many cases of organic disease of the heart, fluids are tolerated only in very small quantities at a time, and scarcely at all in connection with food. This is due also to the inactivity of the absorbents, which results from the congestion of the vessels of the stomach due to the mechanical obstruction of the circulation in the heart. It should also be remarked that in cases of dilatation of the stomach the less fluid taken with the food the better, as there is such an inactive state of the absorbent vessels of the mucous membrane of the stomach in this condition that fluids are retained a long time. With these few exceptions, drinks may be properly used with great advantage in nearly all diseases, particularly in those which require in¬ creased elimination ; hence they are especially indicated in all types and varieties of fevers, in cases of defective nutrition, in inflammation of the liver, inactivity of the liver, biliousness, acute and chronic diseases of the kidneys, constipation of the bowels, inactivity of the skin, rheumatism, gout, and cholera. In the latter disease the copious drinking of cold water has been found to be one of the most efficacious of all known rem¬ edies, as the absorbents of the intestinal tract in this disease will scarcely act at all. Fluids taken pass rapidly through the stomach and intes¬ tinal tract, thus washing out the bowels, carrying away the poisonous elements of disea.se, and aiding nature in her efforts to effect a cure. The restriction of drink is a common practice in both forms of diabetes, and is frequently carried to too great an extreme. A demand for fluids is as much an expression of want on the part of the system as want felt in any other condition, and hence it should be regarded and acceded to, at least in sufficient degree to prevent the patient from too great suffering. Abstinence from Food. — All physicians recognize the fact that in many diseases, especially those of an acute character accompanied with fever, the use of food should be restricted, to a considerable degree. By entire abstinence from food for one or two days, together with active 736 ‘ RATIONAL REMEDIES FOR DISEASE eliminative treatment, many febrile diseases may be checked at the out¬ set. In bowel diseases caused by taking indigestible food, total absti¬ nence from food for a day or two, or the use of a very small quantity of light food once or twice a day, is particularly advantageous. Attacks of asthma when occurring in persons addicted to high living may often be promptly cut short by prohibiting any but the very lightest articles of food for a day or two. In pericarditis and inflammation of the lin¬ ing membrane of the heart, or endocarditis, a very restricted diet should be employed, especially in those who have previously been overfed. Digestibility of Foods . — For the benefit of persons whose digest¬ ive organs are weak, or who desire to preserve them in health by avoid¬ ing articles of food which are difficult of digestion, we have prepared the following tables, which are based upon careful observation and the experiments of Beaumont upon the stomach of Alexis St. Martin. Articles Easy of Digestion.— The following articles are readily digested by a healthy stomach, and can be digested with comparative ease by most dyspeptics : — ANIMAL Raw white of egg, beaten to a froth. Beef tea, free from fat. Raw whole egg, beaten. Milk, fresh and warm. Fresh eggs, soft boiled. Mutton, broiled. FOODS. Yenison steak, broiled. Chicken, especially the white parts. Rabbit. Fresh trout, and most fresh fish which are not oily. VEGETABLE FOODS. Stale bread. Graham rolls, made without yeast or soda. Rice, well boiled or steamed. Tapioca, sago, corn-starch. Oatmeal porridge, eaten with dry toast. Graham mush or crushed wheat. Cauliflower, Asparagus, if very tender. French beans. Baked sweet or subacid apples. Strawberries and whortleberries. Grapes, without skins or seeds. Oranges and bananas. Articles Not Easy of Digestion. — The following list includes the common articles of food which require a considerable degree of vigor on the part of the digestive organs, and must be avoided by all b$d dys¬ peptics : — ANIMAL FOODS. Animal soups of all sorts. Beef. Lamb. Turkey, duck, pigeon. Codfish. Oysters, raw. Butter. All sorts of roast meats. DIGESTIBILITY OF FOODS. i 61 VEGETABLE FOODS. Potatoes. Carrots. Turnips. Spinach. Cabbage. Parsnips. Tomatoes. Vegetable soups. Peas. Corn-meal preparations. Beans. Salads of all sorts. Raisins and most dried fruits. Currants. Apples. Gooseberries. Peaches. Raspberries. Plums. Blackberries. Cherries. Rhubarb. Pineapple. Jelly. Beets. Indigestible Articles. — The following articles, while they may be digested by a vigorous stomach, impair the digestive powers and induce indigestion, and to the dyspeptic are more of the character of poisons than of foods : — ANIMAL Pork. Veal. Goose. Liver. Kidney. Heart. Sausage. Hard-boiled eggs. Scrambled eggs. Cheese. FOODS. Hashed and stewed meats. Salt and smoked meats. Melted butter, and all animal fats. Mackerel, and all oily fish. Salt fish. Dried and smoked fish. Sardines, and other fish preserved in oil. Lobster, crabs, etc. Cooked oysters and clams. Fried meats of all sorts. VEGETABLE FOODS. Warm bread, especially when taken with butter. Muffins. Buttered toast. Pies, cakes, and all sorts of pastry. Pancakes. Fried bread and vegetables. Nuts of all kinds. Onions. Mushrooms. Pickles. Tea, coffee, cocoa, chocolate. Mustard, pepper, spices, and other con¬ diments. Sugar, preserves, and all saccharine foods. Nutritive Injections. — In certain diseases of the stomach, as in gas¬ tric ulcer, inflammation of the stomach, chronic gastritis, enlargement of 47 738 RATIONAL REMEDIES FOR DISEASE. the stomach, and the vomiting of pregnancy, it is often necessary to allow the stomach to rest for days, and in some cases even for weeks, no food being taken in the usual way. In these cases it is of greatest impor¬ tance that the proper nutritive injections, or enemata, should be employed. The idea that soups, beef tea, milk, or other undigested food, may be digested iu the rectum and absorbed, thus nourishing the system, is with¬ out foundation. But, as elsewhere remarked, recent discoveries have given grounds for the supposition that food injected into the rectum is carried up into the small intestine, where it may undergo digestion in the reg¬ ular way. When possible, however, on account of the weakened condi¬ tion of the digestion and the possibility that the undigested food may not be carried into the small intestine, the food should be artificially digested, at least in part, or should be so prepared that it will undergo digestion after introduction into the bowels. There are several methods of prepar¬ ing food for this purpose, all of which are highly recommended. The value of the following preparations for use as nutritive enemata we have frequently and thoroughly proven by experience in the treatment of cases in which they were required, having kept patients for weeks on little else than the nutritive enemata. We are acquainted with cases in which life has been well sustained for months in this way. Heat Solution. — Take two pounds of lean beef, cut into small pieces and put into a pint of blood-warm water. Add twenty-five ■drops of pure hydrochloric acid and half a teaspoonful of pepsin. Keep it at a temperature of about 100° F. for six hours, or until the meat becomes disintegrated, stirring frequently ; then strain and add half a teaspoonful of bi-carbonate of soda to neutralize the acidity. This highly nutritious fluid should be administered in quantities of not more than two or three ounces, and repeated once in three or four hours. The bowels should be emptied by a copious enema an hour before administering the injection. This rule applies to all forms of rectal feeding. Pancreas and Meat Solution. — Take fresh beef pancreas, care¬ fully remove all fat, cut two ounces, about two heaping tablespoonfuls, into very small pieces. Take of finely scraped or ground beef, also free from fat and sinew, double the quantity of pancreas. Mix with two-thirds of a teacupful of warm — not hot — water. Stir until well broken up. Inject into the rectum through a large tube. About half .should be injected at once, and the injection should be made slowly, so USEFUL DIETETIC RECIPES. 739 as to prevent its discharge before absorption has taken place. If necessary, a napkin should be held against the anus until the disposi¬ tion to move ceases. Pancreas and Cream. — Chop very fine three ounces of fresh beef pancreas. Add two tablespoonfuls of warm water and a teacupful of sweet cream. Mix thoroughly in a small pail. Cover and place in a pan of water blood- warm. Keep at this temperature for from one- half to three-quarters of an hour, stirring frequently. At the end of this time strain through a coarse colander, rubbing through as much as possible of the pancreas, and inject into the rectum. If the patient will not retain all at first, use half the quantity, keeping the balance in a refrigerator until needed for use. Then warm to the proper temperature and inject as before. Beef Tea and Egg. — Beat lightly one egg with four tablespoon¬ fuls of strong beef tea. Inject as directed before. This is the most nourishing of any preparation which can be employed for this purpose, and as it is easily prepared should be resorted to whenever a patient cannot be nourished by the stomach. USEFUL DIETETIC RECIPES. Milk and Lime-Water. — In many cases in which milk is indi¬ cated as an important article of diet, indeed, as the most important of all foods, as in young infants, it cannot be taken without distress on account of the large, tough curds which it forms in the stomach. For cases of this sort, ordinary cow’s milk may be mixed with lime-water in the proportion of a large teaspoonful of lime-water to a tumblerful of milk. If the difficulty still continues, the lime-water may be used in the proportion of one part to two of milk. Barley-water will in most cases answer as well as lime-water. Brail Tea. — Soak a teacupful of bran in cold water over night in a cool place. Simmer for half an hour, and strain through a cloth. A soothing drink, said to encourage activity of the bowels. We have not much confidence in its laxative properties. It is a good wash for irritated surfaces. Brail or Wheat CofFee. — Mix bran and molasses to a stiff paste, spread on a tin and brown in the oven. Brown wheat in the same way. Be careful not to allow the heat to be sufficient to burn or 740 RATIONAL REMEDIES FOR DISEASE. scorch. Use as other coffee, for which it is a good and unstimulating substitute. Wheat coffee is sometimes sold at the stores in packages. Acorn Coffee. — Select plump, round acorns. Shell, and brown in an oven. Grind in a coffee-mill, and use as ordinary coffee. A good drink for children suffering with diarrhea, on account of the tannin which it contains. It is also recommended for scrofulous persons. Water Gruel. — Over a dessert-spoonful of finely ground oatmeal, mixed with a tablespoonful of cold water, pour a pint of boiling water; let it settle two or three minutes, then pour off the water carefully, leaving the coarser part of the meal. Boil ten or fifteen minutes, stir¬ ring frequently. Milk Gruel. — Into a pint of scalding milk stir two tablespoonfuls of fine oatmeal. Add a pint of boiling water and boil until the meal is thoroughly cooked. Oatmeal Gruel. — Stir two tablespoonfuls of coarse oatmeal into a quart of boiling water, and let it simmer at least two hours. Strain if preferred. Rice Gruel. — Soak two tablespoonfuls of fine rice for half an hour in cold water. Pour off the water ; add a pint of milk and let it sim¬ mer until the rice is tender. Press through a sieve and then dilute with milk. Heat again for a few moments; pour off to cool, and flavor with a little salt or sugar. Milk Porridge. — Place over the fire equal parts of milk and water. Just before it boils, add a small quantity (a tablespoonful to a pint of water) of graham flour or corn meal, previously mixed with wTater, and boil a minute longer. Rice and Apple. — Stew two or three large, ripe apples to a pulp and sweeten with a little white sugar. Then boil a half teacupful of rice in milk until it is quite tender. Put the rice round a plate with the apples in the center and serve. A dish which most invalids, unless bad dyspeptics, will readily digest. Excellent for fever convalescents. Rice Blanc-Mange. — Heat one quart of milk to near boiling ; then stir into it one-fourth of a pound of finely ground rice previously mixed to a smooth batter with a little milk. Add two spoonfuls of white sugar and let it boil until thick enough to mold, stirring it all the time. Flavor, while boiling, with a little lemon or pine-apple. Serve cold. USEFUL DIETETIC RECIPES. 741 Arrow-Root Blanc-Mange.— Bring a pint of milk to boiling point, add a batter made by mixing two tablespoonfuls of arrow-root with , a little milk, and let it boil. Sweeten and flavor to the taste, stirrino- , assiduously until it thickens sufficiently to mold. Corn-starch blanc¬ mange may be made by this same recipe by using the above propor¬ tion of corn-starch instead of arrow-root. Egg-Nog. — Beat one egg and a teaspoonful of refined sugar to a stiff froth ; add a teaspoonful of lemon-juice ; pour in a glass, and fill up with water. White of Egg ami Milk . — The white of an egg beaten to a stiff froth and stirred very quickly into a glass of milk is a very nourish¬ ing food for persons whose digestion is weak, also for children who cannot digest clear milk. The white of egg has a tendency to prevent the formation of hard curds in the stomach. White of Egg. — Stir the white of an egg into a tumblerful of cool water, or water warm as it can be without coagulating the egg. Give to infants suffering from extreme disorder of digestion and un¬ able to take milk. This simple mixture has saved many an infant’s life. Beef Tea. — For every quart of beef tea desired, use one pound 01 fresh beef from which all fat, bones, and sinews, have been carefully removed. Cut the beef into pieces a quarter of an inch square, or grind in a sausage-grinder, and soak over night in a small quantity of water (a pint will do). Take the beef out and let it simmer gently in a larger quantity of water for two or three hours, replacing from time to time the water lost by evaporation. Afterward pour together the boiling liquor and the cold liquid in which the beef was soaked. Another Method. — Take a pound of fresh beef prepared as above, and mix with a pint of cold water. Let it stand an hour ; then pour into a glass fruit-can, or large-mouthed stone jar, and place in a vessel of water ; let it heat on the stove another hour, being careful not to allow it to boil. Strain through a fine cloth or filter before using. Flaxseed Tea. — Take an ounce of whole flaxseed, half an ounce of crushed licorice root, an ounce of refined sugar, and four tablespoon¬ fuls of lemon juice. Pour over these ingredients a quart of boiling water ; let this stand near the fire for four hours, and then strain off the liquid. The flaxseed should not be crushed, as the mucilage is in the outer part of the kernel and if bruised the boiling water will ex- 742 RATIONAL REMEDIES FOR DISEASE. tract the oil of the seed and render the decoction nauseous. The tea should be made fresh daily. Barley-Water. — Take half a teacupful of good pearl barley. First wash it thoroughly ; then boil five or ten minutes in fresh water. Drain off this water and pour on two quarts of boiling water and boil down to one quart. Flavor if desired with a little lemon or sugar. Thin to required consistency with boiling water. Currant-Jelly W ater. — A tablespoonful of currant jelly stirred into a glass of cold water makes a pleasant beverage for fever patients. Apple Water. — Wipe two or three ripe, tart apples, and slice, without paring, into a dish and pour over them a quart of scalding water. Let stand until cool ; then turn off water and sweeten. Toast Water. — Brown a slice of stale bread or crust thoroughly, but do not allow it to blacken or burn. Break the toast into small pieces and put into an earthen dish or jug ; pour over the pieces a quart of boiling water ; cover the dish tightly, and let the mixture re¬ main until cold. When strained it will be ready for use. Lemonade. — Mix the slices and the juice of two lemons with three spoonfuls of refined sugar and add a pint of cold or iced water. Hot Lemonade. — Take two thin slices and the juice of one lemon ; mix with it two teaspoonfuls of white granulated sugar, and add one half pint of boiling water. A very useful drink for a person when exhausted. A splendid substitute for tea and coffee. Sago Jelly.— Simmer gently in a pint of water two tablespoon¬ fuls of sago until it thickens, frequently stirring. A little sugar may be added if desired. Bread Jelly. — Pour boiling water over bread crumbs ; place the mixture on the fire and let it boil till it is perfectly smooth. Take it off, and after pouring off the water, flavor with something agreeable, as a little raspberry or currant jelly water. Pour into a mold until re- quired for use. Tapioca Jelly. — Take two tablespoonfuls of tapioca and one pint of water; let it simmer until it becomes thick like jelly. A little lemon juice and sugar may be added. Gum-Arabic W ater. — Put an ounce of choice gum arabic into a jar with two ounces of refined sugar and a pint of water. Place the jar in a sauce-pan of warm water and stir until dissolved. Add a lit¬ tle lemon to flavor. This is a good drink for consumptives. MISCELLANEOUS REMEDIES. 743 Diabetic Dread. — No. 1. Take a sufficient quantity (say a quart) of wheat bran, boil it in two successive waters for a quarter of an hour, each time straining it through a sieve, then wash it well with cold water (on the sieve) until the water runs off perfectly clear ; squeeze the bran, in a cloth as dry as possible, then spread it thinly on a dish and place it in a slow oven ; if put in at night let it remain until the morning,, when, if perfectly dry and crisp, it will be fit for grinding. The bran thus prepared must be ground in a fine mill and sifted through a wire sieve of such fineness as to require the use of a brush to pass it through. That which remains in the sieve must be ground again until it becomes, quite soft and fine. Take of this bran powder three ounces (some pa¬ tients use four ounces), three eggs, and about half a pint of cream ; mix the egg with a little of the cream and warm the other portion ; then stir the whole well together, adding a little nutmeg or cinnamon, or any other agreeable spice. Bake in small tins, which must be well buttered, in a rather quick oven for about half an hour. The cakes, when baked, should be a little thicker than a sea-biscuit. They may be eaten with meat, milk, curd, or buttermilk. Diabetic Bread.— No. 2. Reduce to a fine powder in a mortar, a quarter of a pound of blanched almonds. Tie up in a bag and throw into boiling water which has been acidulated with lemon for fifteen © minutes. Then beat to a froth and add the whites of three eggs. MEDICINAL AGENTS AND MISCELLANEOUS REMEDIES, Under this head we shall consider briefly the principal drugs em¬ ployed in medicine, together with miscellaneous remedies not included, under any of the preceding heads. We have purposely omitted giving the doses of the majority of medicinal agents mentioned, believing, as- previously remarked, that the administration of drugs capable of pro¬ ducing injurious or poisonous effects should be discouraged, to accom¬ plish which is, indeed, one of the objects of this work, for which rea¬ son we have devoted so much space to a consideration of hygienic or non-medicinal remedies. In a great majority of cases in which drugs may be usefully employed in the treatment of disease, the services of an intelligent physician are required, and the regulation of the doses- may be properly left to him. Indeed, there can be no absolute ruie as to the proper doses of medicines, so different is their action, so-called, un¬ der different circumstances, in different conditions of the system and hr 741 RATIONAL REMEDIES FOR DISEASE. different individuals. Any one who wishes to obtain more precise and extended information regarding the various medicinal agents men¬ tioned may readily do so by referring to almost any one of the nu¬ merous excellent works on materia medica and therapeutics which ex¬ ist at the present time. With reference to the so-called “ action ” of drugs, we need but remind the reader of our previous discussion of the subject, in which we have endeavored to show that what is termed the action of the medicinal property of the drug is really simply a mode of expressing the manner in which the vital, organism acts upon it. Further remarks will be made on this subject in connection with the different classes of medicine which will be referred to. In our consideration of the various classes of medicine we have closely followed the order of classification adopted by Dr. H. C. Wood, in the last edition of his “ Therapeutics, Materia Medica, and Toxi¬ cology.” Tonics.— Tonics are drugs which are supposed to increase vital strength, and hence they are chiefly used in diseases and conditions characterized by debility. Numerous theories have been advanced to explain their supposed action, but none which seems to us more satisfac¬ tory or more capable of logical proof than that of Dr. Guy, of London, who asserts that their effects ai’e produced in precisely the same manner in which the effects of stimulants are produced. As we have already seen, stimulants seem to produce an increase of strength simply by ir¬ ritation, by means of which the forces of the system are developed re¬ ally in antagonism to the influence of the drug, though sometimes in¬ cidentally to some useful purpose also. The effects occasioned by ton¬ ics are much less marked than those of stimulants, but it cannot be shown that they are in any way different except in degree. There are, doubtless, cases in which the use of tonics occasions more good than harm, yet we firmly believe that an immense amount of harm has been done by a false reliance upon tonics to accomplish what can only be effected through the medium of good food, pure air, sunshine, and obedience to all the laws of hygiene. We are also thoroughly con¬ vinced from observation and treatment of hundreds of cases of debil¬ ity in all its various forms and stages, that far greater benefit is to be derived from the invigorating influence of such agents as sunshine, and an abundance of pure air, together with the proper application of message, water, electricity, and other hygienic remedial agents, than from all the medicinal tonics that can be brought to bear in such cases. MISCELLANEOUS REMEDIES. 745 We have, in fact, by these means restored to health many persons who had tried in vain the whole list of medicinal tonics afforded by what an eminent physician is pleased to call the “ polypharmacy of the text¬ books.” The principal drugs employed for supposed tonic effects are clas¬ sified as bitters, aromatics, and mineral tonics. Some of the more commonly employed of the first class are quassia, gentian, columbo, boneset, gold-thread, salicin, wild-cherry bark, cin¬ chona, quinine, and other preparations from Peruvian bark, strych¬ nia, chamomile, and Virginia snake root. The second class is chiefly composed of the various substances em¬ ployed as condiments, including cinnamon, cloves, allspice, black pep¬ per, red pepper, cardamoms, etc. Under the head of mineral tonics are included all the different prep¬ arations of iron, sulphuric acid, nitric acid, muriatic acid, nitro- muriatic acid, lactic acid, and phosphorus. Of the above-mentioned drugs we will notice but a very few. The whole class of bitters may be represented by the chief of them, — quinine. The rational view of their tonic effects we have already explained, but they possess another curious property to which we shall call attention ; namely, the power to destroy the regularity of the paroxysms in peri¬ odic diseases, as ague and remittent fever, from which they are called antiperiodics. Quinine is about the only one, however, which is em¬ ployed for antiperiodic purposes, as this property is too feeble in most of the other bitters to be of much practical account. Just how quinine will interrupt the progress of a malarial fever has been an interesting subject for discussion ever since this peculiar property of the drug was discovered. That it will do so, there is no chance to question. How the effect is produced, is not so clear. Various theories have been pro¬ pounded, all of which have, however, seemed to us to be erroneous, since they are all based on the supposition that the drug is, the active agent, and the system the recipient of some action performed upon it. Dr. Headland in his work on the action of medicines proposes an in¬ genious theory that quinine is a natural constituent of the blood, and that in persons suffering with malarial disease, this element is lacking, and that, consequently, quinine is beneficial by restoring to the blood an important element which is in these cases deficient. Unfortunately for this theory, however, it can produce no well-ascertained facts in its sup¬ port. Quinine has never yet been found in the blood, and when we 74G RATIONAL REMEDIES FOR DISEASE. consider the source of this alkaloid, it being obtained from the bark of a South American tree, it seems wholly improbable that any such discov¬ ery will be made. Even if it should be proven that quinine were a nat¬ ural constituent of the blood, it would still remain to be shown that it is deficient in persons suffering with malarial diseases, and that the admin¬ istration of the druof in the form in which it is used in medicine could supply the deficiency. Our own theory, which our experience with the use of the drug in antiperiodic diseases has seemed to confirm, is that its utility is wholly due to a sort of substitutive action. In other words, we believe that when quinine is administered to a person suffering with malarial disease of any form with the result of causing a cessation of morbid symptoms the result produced is brought about in this way : The symptoms of malarial disease are undoubtedly produced by the resistance of the vital organism to the encroachments of a morbid poison of some sort, probably of organic germs. When quinine is introduced into the system in suffi¬ cient doses, a new morbid action is set up in the resistance of the system to the quinine, or its efforts to expel it from the vital domain, and thus the attention of the organism is distracted from its efforts against the malarial poison, and so the symptoms peculiar to that kind of morbid action cease. In other words, the malarial disease is cured. There is no doubt, however, that the cause of the disease — malarial germs or other specific poison — remains in the system, since, as is well known, the disorder when broken up in this way is very apt to return again. The use of quinine is successful in curing ague, simply because it interrupts the paroxysms which occur in this disease. Any agent which will effect the same result, that is, the interruption of the par¬ oxysm, will cure the disease, as we shall elsewhere show more fully in considering the treatment of ague and remittent fever. We do not wish to be understood as arguing against the use of qui¬ nine as an antiperiodic, as we believe it to be one of the most useful of all medicinal agents on account of its efficiency in interrupting the par¬ oxysms of malarial disease. It is but fair to add, however, that the same result may be accomplished by numerous other agents, as well as quinine. We have cured many cases of malarial disease in which the symptoms were well marked, without the use of a single grain of qui¬ nine, or, in fact, of drugs of any kind. Directions for the use of quinine in malarial disorders will be given in connection with the treatment of those diseases. MINERAL TONICS. 747 Strychnia is looked upon as one of the most powerful of all the tonics employed in medicine. It is one of the most violent and certainly fatal poisons known. 1 1 has been much used in paralysis and some forms of dyspepsia, and in nervous debility. When administered even in very minute doses it seems to call forth the most powerful resistance on the part of the system, causing, in any but the smallest doses, violent tetanic convulsions. No certain antidote for its effects is known, and severe cases of poisoning by it are almost certainly fatal. From experiments which have been made, we are strongly inclined to believe that the use of apparatus for the inhalation of compressed, and exhalation into it of rarefied air, would be found to be of benefit. Mineral Tonics. — Of the mineral tonics, by far the most largely used is iron, of which a very large number of preparations are employed. As this is the chief of all the mineral tonics we will confine our observa¬ tions to it alone. Many years ago, Prof. Liebig, a noted German chemist, made a chemical analysis of the blood, and found iron in it. He claimed to prove by his experiments that the color of the red corpuscles of the blood was due to the presence in them of the oxide of iron, which was sup¬ posed to play a very important part in the transmission of oxygen from the lungs to the tissues, and the removal of carbon di-oxide (commonly called carbonic acid) from the system. Since these supposed discoveries were made it has been taught that iron constitutes an essential part of the coloring matter of the blood. The name applied to this peculiar compound is ham at os in. Whenever a person is found to be deficient in red blood corpuscles, as is the case in most invalids, especially dyspeptics, iron is administered, either in its me¬ tallic state or in combination with some acid. In this way it has been supposed that red blood corpuscles could be increased in a person’s blood, and the theory has given rise to numberless quack medicines which are sold under the various names, “blood tonics,” “iron tonics,” “ iron bitters,” etc. Unfortunately for this theory, it has been proved, according to the Popular Science Monthly, by the experiments of Mal- der and Van Gondovcr, two distinguished chemists, that the coloring matter of the blood contains no iron. If these experiments are reliable, and we have no reason to believe that they are not, the practice of ad¬ ministering iron to improve the color of the blood is left without foundation. It seems, also, that eminent medical savants are beginning to take the 748 RATIONAL REMEDIES FOR DISEASE. same view respecting this drug. According to the Boston Medical and Surgical Journal, M. Dujardin-Beaumetz is not a believer in the ther¬ apeutical virtues of iron in anemia and chlorosis. Notwithstanding the existence of a lessened quantity of iron in the blood of anemic and chlorotic patients, he says that this diminution is of very little conse¬ quence, being ten to twenty centigrammes, at the most, of the total amount of two grammes of iron in five litres of the blood of an average¬ sized adult. Now, according to Boussingault, the daily food introduces into the body more than this quantity of iron ; consequently, the loss of iron may be made up by the food alone. When a student at college, we were particularly struck by the re¬ marks of our professor of materia medica on the value of iron as a tonic. He stated with great emphasis that his experience with the drug had been that patients suffering with anemia might be dosed with any amount of iron but no effect would be obtained unless they were sent out to exercise in the fresh air and sunshine, when good results would be at once observed. The query arose in our mind at the time, for which we have never found any but an affirmative answer, whether it would not be equally well for the patient to send him out into the fresh air and sunshine without plying his stomach with doses of iron. In cases in which we have used the iron for tonic purposes, depending upon it alone so as to be able to judge accurately of its effects, we have never observed any benefit whatever. We are aware that statements of this kind will be considered very rash and bold, but we feel less hesitancy in making them since we are able to cite the testimony of so eminent a physician as Dr. Dujardin-Beaumetz in favor of the same position. Having had quite extended opportunities of testing other methods of treatment in the cases in which iron is usually prescribed and after it had been thoroughly and faithfully used for a long time, we may per¬ haps be pardoned for being exceedingly skeptical as to its beneficial effects. Heart Stimulants. — The drugs enumerated under this head are ammonia and its compounds, alcohol in all its forms, turpentine , and digitalis. Ammonia, the first-mentioned of these, is a colorless, irrespirable, highly irritant gas, of a strong alkaline reaction, and very soluble in water. Aqua ammonia, or ammonia water, is simply water which has been impregnated with ammonia gas. Applied to the skin, ammonia is a powerful irritant ; and when inhaled, causes irritation of the air- HEART SEDATIVES. 749 passages, and even inflammation. One of the most common uses of am¬ monia is to prevent syncope, or fainting, when strong symptoms tending- in that direction are manifested. Bv its irritating effects it excites the lungs and heart to increased activity. It acts, in fact, like a whip upon a tired horse. It gives no strength, but simply compels the organs which recognize it to use the force which they already have. Alcohol and its relations to the human organism, in disease as well as in health, have been dwelt upon at so great length elsewhere that we need nox give the subject further notice here. Digitalis is often prescribed in organic disease of the heart, but its use is attended with considerable danger, as it is a powerful poison, and not infrequently the effects of the first dose are not fully felt until three or four doses have been given, when the effects of the accumulated quan¬ tity received are experienced together, and sometimes with fatal results. As a means of increasing the heart’s impulse in organic diseases of this organ, we have found it vastly inferior to galvanism applied to the pneumogastric and sympathetic nerves. Heart Sedatives. — The principal drugs included in this class are antimony and its preparations, arnica, veratrum viricle, aconite, hydro¬ cyanic acid, cyanide of 'potassium, and vegetable acids. With the exception of the vegetable acids, all the drugs included in this list are powerful poisons. Their effects, whether administered in health or dis¬ ease, are essentially those of poisoning, the principal effect being a great decrease in the activity of the heart’s action. Antimony, in the form of tartar emetic, is so named from the fact that its discoverer experimented with it as medicine upon several Spanish monks, who died from its effects. F rom this it was called antimony, which is derived from two Spanish words meaning “ anti-monk.” Three- quarters of a grain in a child and two grains in an adult, in the form of tartar emetic, has produced death. The vegetable acids can hardly be considered as drugs, since when taken in their natural form they are really foods, being taken and di¬ gested by the system. When taken in large doses they sometimes pro¬ duce symptoms resembling those of the other poisonous substances men¬ tioned under this head, whence they have been put in this class. Citric Acid in the form of lemon juice is a very valuable agent in the treatment of several diseases. Its value in scurvy has long been known, and is now so well recognized that whaling ships and othei 750 RATIONAL REMEDIES FOR DISEASE. vessels going- on long voyages in which it will be impossible to obtain an abundant supply of fresh fruits and vegetables, always take with them a supply of preserved lemon juice as a preventive against the oc¬ currence of scurvy. The free use of lemon juice is also to be recom¬ mended in acute rheumatism, in jaundice due to a catarrhal condition of the biliary ducts, in chronic inactivity of the liver, and in some forms of constipation of the bowels. Lemonade is also a very valuable drink in fevers, on account of its cooling properties. The free use of lemons in malarial fevers sometimes appears to have a decided influence in cutting short the disease. Arnica, another member of this class of drugs, has been much used as a liniment in bruises and wounds of various kinds. Frequently, how¬ ever, it has been observed that decided effects of poisoning have followed its use in this way, and many physicians have recently abandoned its use on this account. Quite a number of eminent English physicians condemn its use in the strongest terms as a poison which should never be employed under any circumstances. When used as a liniment it very frequently causes serious skin eruptions which are a long time in healing. It has no effect whatever to hasten the healing of wounds, its only influ¬ ence being to diminish pain by its paralyzing effect upon the sensitive nerves with which it is brought in contact. As the same result can be accomplished by other means which are not open to the objections that are justly urged against this, we heartily agree with those who con¬ demn its use. Prussic Acid, like arnica and antimony, is a powerful poison. In¬ deed, it is without doubt the most rapidly fatal drug in use. It is never kept in a pure state, as its vapor alone is sufficiently poisonous to produce fatal effects. It is frequently used in combination with 'potassium as cyanide of potassium, which almost equals it in poisonous properties. The poisonous character of cyanide of potassium should be kept in mind, as this drug is frequently used in the household for removing nitrate-of- silver stains from the fingers and from linen. Since this can be accom¬ plished by other means it is best that the drug should not be kept about the house, as it produces death so quickly that there is little hope of sav¬ ing the life of a person who has taken a dose of it, by the use of any an¬ tidotal means. It should be further remarked in this connection that the peculiar flavor of bitter almonds and of the kernel of the peach seed is due to the presence of this poison. The use of bitter almonds for fla¬ voring purposes Is worthy of strong condemnation. Though the amount ANTISPASMODICS. 751 of the drug thus employed might be very small, it could not possibly be of benefit. Antispasmodics. — This class includes musk, castor, valerian, assa- fetida, camphor, hops, lactucarium, coffee, etc. These drugs are called antispasmodics because used in those condi¬ tions of the nervous system included under the head of nervousness, together with exaggerated forms of the same conditions, such as hys¬ teria, and various other convulsive disorders. How the effects of these drugs in relieving nervousness and interrupting convulsions are pro¬ duced, our works on materia medica and therapeutics do not explain. There can be no doubt, however, that their apparent action, as is the case with other drugs, is wholly due to the reactions of the various parts of the system against them as foreign elements in the vital do¬ main. Several members of this class are violent poisons. Assafetida, a drug very frequently used for the relief of hysteria and nervous¬ ness, is in some Eastern countries used in very small quantities as a condiment. It has a very offensive taste and odor, and it is exceed¬ ingly strange that it should ever have acquired a use of this sort. The medicinal properties of hops are due to a substance which they contain called lupulin. People frequently find their insomnia re¬ lieved by the use of hop pillows. The soothing effect of a hop poul¬ tice when applied to painful parts is well known. It is, perhaps, one of the mildest narcotics which is used in this way. The poultice may be made by simply pouring hot water on the hops contained in a . gauze bag of the right size and shape, which is applied to the pain¬ ful part, or by mixing the hops with Indian meal and making a poultice with hot water. Lactucarium is a medicinal substance obtained from lettuce. It is said to have narcotic effects, but these are so slight that even the most concentrated preparation has been taken in very large quantity without producing any effect whatever. It is probable that it may have some slight effects. Coffee is still classed among other drugs as a medicine. It properly belongs with medicinal agents, and is, consequently, wholly unfit for daily use as an article of diet. Ordinary tea, Paraguay tea, and all other substances which contain caffeine, possess essentially the same properties as coffee. Strong coffee has been found to be a valuable means of counteracting the effects of poisoning by opium. This is 752 . RATIONAL REMEDIES FOR DISEASE. about the only good tiling we can say of this almost universally abused drug. Anodynes. — This term is applied to drugs which are used for the relief of pain. AVe shall mention under this head only opium, mor¬ phia, Indian hemp, belladonna, and hyoscyamus. These drugs are all characterized by their power to relieve pain, an effect which is due to their benumbing influence upon the brain, the seat of sensibility. They are more largely used, perhaps, than any other class of drugs employed in medicine. This is especially true of opium, the chief of all agents for the relief of neuralgia and many other painful affections. Morphia has a still more powerful effect than opium, being a concentrated extract from the crude drug. While these agents are of the greatest service in affording relief from pain and suffering which is beyond the hope of cure or cannot be reached, they are abused to an extent which is fearful to contemplate. Sufficient has perhaps been said with reference to the employment of opium in the opium habit, and we shall not repeat our previous observations on this subject. We will, however, simply revert to the fact that it is the medicinal use of the drug which in the majority of cases leads to its habitual employment. We cannot but regard the reckless manner in which opium and other anodynes are used by many, perhaps the larger share of physicians, as in the highest degree worthy of condemnation. Phy¬ sicians often forget that the relief of the prominent symptoms of a case is but a small part of the work which must be done if a cure is to be effected. The relief of symptoms we regard, indeed, as but a small part of the physician’s duty. His first work should be to find out the cause of the suffering, and then he should set to work to remove this cause at the earliest possible moment. If it can be quickly removed, no other means for removing the pain need be employed, as the re¬ moval of the cause will itself bring relief. If, however, the cause is found to be of such a nature that it cannot be removed at once, but considerable time must elapse before relief can be obtained in this way, it is often the duty of the physician to employ such other means as may be necessary to mitigate the sufferings of his patient suffi¬ ciently to secure for him the greatest degree of comfort compatible with his best interests. By the employment of ingenuity and the proper degree of painstaking it will be found possible in a very large proportion of cases in which opium and other anodynes are commonly MORPHIA AMD OPIUM. 753 employed, to obtain relief without resorting to remedies of this class, and we regard it as the solemn duty of every physician to give such remedies only in cases of actual necessity. All physicians who have observed carefully the effects of their prescriptions, are aware that anodynes benumb and depress the activity of the organic nerve cells of the nerves of sensibility, and consequently under their influence the various processes necessary to nutrition and the other organic func¬ tions cannot be so well performed as when the system is not under the influence of paralyzing drugs. Consequently it is evident that recov¬ ery must in some degree be impeded by the use of anodyne rem¬ edies. Electricity, when properly used, will be found in many cases to be a perfect substitute for anodyne drugs, and it is never attended with any of the unpleasant effects which follow the use of such reme¬ dies as opium, morphia, and other drugs of that class. The sleep af¬ forded by the narcotic effects of opium is by no means so refreshing as natural sleep. Indeed, we fully indorse the statement made by an emi¬ nent physician at the International Medical Convention, held at Phil¬ adelphia in 1876, that one hour of natural sleep is equal to three or four hours of narcotic insensibility. In many cases the use of ano¬ dynes can be avoided by urging the patient to bear with fortitude his sufferings, which may be quite too slight to require the use of such powerful remedies as must be applied to secure entire insensibility to pain. In the case of habitual opium-eaters we have found the greatest obstacle to recovery to be the entire loss of fortitude to endure even a very slight degree of pain, which condition had doubtless been brought about by the habit of taking the narcotic for the relief of every unpleasant sensation. We have no sympathy with the class of medical fanatics who would allow a patient to die from sheer exhaus¬ tion from pain rather than administer a narcotic. We frequently find it necessary in practice to employ opium, morphia, belladonna, and in fact, the whole list of anodyne remedies ; but we restrict the use of these drugs as much as possible, and exhaust every other means of relieving pain before resorting to them. This is the practice which we heartily commend to every physician, and which ought to be insisted upon by all intelligent persons so far as their influence may extend. The common and almost unrestricted use of opium by physicians has made the common people so familiar with the drug that its poisonous properties are seldom thought of. It is regarded as a great boon for 48 RATIONAL REMEDIES FOR DISEASE. 754 the relief of pain, as it is, and so is resorted to on any and every occasion when discomfort is experienced which cannot he relieved oth¬ erwise. This ignorance or apathy respecting the injurious properties of the drug undoubtedly lies at the bottom of that most pernicious practice, — the use of anodynes in the form of paregoric, Mrs. Wins¬ low’s Soothing Syrup, and other narcotic or anodyne mixtures for the purpose of quieting restless or troublesome infants. Thousands of in¬ fants die annually in consequence of this pernicious practice, and we cannot help believing, in view of this terrible sacrifice of human life, that it would be a boon, to the rising generation at least, if narcotics and anodynes of every sort were blotted out of existence. The treat¬ ment of opium poisoning and the opium habit are fully considered in other connections. Belladonna, another prominent member of this group of drugs, is also very largely used as an anodyne, although to a far less extent than opium, in its various preparations. One of the most character¬ istic effects of belladonna is its power to dilate the pupil of the eye. This was one of its first observed effects, and the drug has been very largely used by ladies for this purpose in order to give to the eye an increased brilliancy. In certain diseases of the eye in which inflam¬ mation of the structures about the pupil occasion danger to the sight by causing adhesion of the iris to the cornea or lens in such a posi¬ tion as to prevent the admission of light into the eye, belladonna has an exceedingly useful effect to produce dilatation of the pupil, thus withdrawing the iris from the seat of danger until the inflammation has been subdued by the proper means. We have seen many eyes saved by this means which would otherwise undoubtedly have been sacrificed. Belladonna is also of great service to the oculist by en¬ abling him to dilate the pupil to such an extent as to admit of a thor¬ ough examination of the whole interior of the eye by means of an ophthalmoscope. This drug has also been found to be a physiological antidote for opium-poisoning. Hyoscyamus and stramonium produce an effect upon the eye sim¬ ilar to that of belladonna, though in a much less degree. Anesthetics. — This is a class of drugs which occasion the loss of consciousness by the inhalation of their vapor. Their effects are very largely due to their exceeding volatility, by means of which they are taken into the system very rapidly. Various theories have been proposed to account for their effects. The most probable is that their so-called CHLOROFORM. i o •> action is anti-vital ; that is, wholly due to the reaction of the system against them. The principal anesthetics are chloroform, ether, bi¬ chloride of methyl, and nitrous oxide. Chloroform is produced by the action of chlorine upon alcohol. It has a hot and sweetish taste, and a fragrant and peculiar odor. It is heavier than water, and sinks when dropped into it. AVhen placed upon the skin and covered with a cloth, it will cause a blister; and when taken into the mouth or stomach, produces a burning sensation. When inhaled, it causes first a feeling of excitement or exhilaration accompanied by roaring in the ears, with strange and peculiar sensa¬ tions. The patient generally has a feeling as though the objects im¬ mediately about him were a long distance off. This gradually fades into semi-unconsciousness, which is accompanied with visions and illu¬ sions. During this stage, patients weep, laugh, talk, pray, rave, or be¬ come violently obnoxious. This stage usually lasts but a few min¬ utes, and gradually passes off, when the patient sinks into complete unconsciousness. The first stage very closely resembles that of alco¬ holic intoxication. In the second stage the patient is unconscious, and lies perfectly quiet. It is during this condition that surgical opera¬ tions are performed. If the inhalation of vapor is continued, the third stage is produced, which is one of narcotic poisoning accompanied by stertorous breathing and complete relaxation of the muscles. It is one of great danger, and should be carefully avoided in the administration of chloroform. In the first stage the pulse is very greatly quickened in the second stage it should be about normal ; in the third stage it becomes very weak and frequent. Chloroform has a very depressing^ influence upon the heart. In cases of death from its use, the result is generally due to paralysis of the heart. Of the two most largely used anesthetics, chloroform and ether, chloroform is without doubt by far the most dangerous. It has been shown by carefully collated statis¬ tics that it produces death on an average in about one case in 3,000 inhalations. The treatment for threatened death during chloroform inhalation is given under the head of “Artificial Respiration.” The danger in the use of chloroform is now generally conceded by experienced surgeons to be so great as to render its use unjustifiable except in cases where ether cannot be well employed. Although its inhalation is much pleasanter for the patient, and its greater potency as an anesthetic renders the use of a smaller quantity sufficient to produce the desired result, these advantages are overbalanced by the 756 RATIONAL REMEDIES FOR DISEASE. greater danger to life entailed by its use. Experiments made at the Philadelphia Hospital have shown that persons may be anesthetized with chloroform in sound sleep without being awakened, and there is some evidence to show that the drug has sometimes been employed in this way by burglars for aiding them in their operations. Persons who are sleeping lightly, however, will be awakened by the strong- odor and irritating effects of the gas. Ether is a colorless, volatile liquid obtained by treating alcohol with sulphuric acid. It is very inflammable. Its vapor is two and one- half times heavier than air. It has a very strong, peculiar odor and taste. When inhaled, its effects are similar to those of chloroform. It produces in addition unpleasant choking sensations, which fre¬ quently cause great discomfort to the patient. The effect of ether is different from that of chloroform, also, in producing, a short time af¬ ter the giving of the inhalation, a brief period of at least partial un¬ consciousness and insensibility sufficient to allow the performance of short, even though painful, operations. In the performance of such surgical operations as the removal of the toe-nail, circumcision, and similar operations requiring but a few minutes for their completion, we always endeavor to take advantage of this short period of insensi¬ bility to pain, and thus avoid the necessity for the inhalation of so large a quantity of this drug as is usually necessary to produce pro¬ found anesthesia. We have in some instances performed quite severe operations in this manner while the patient was entirely conscious, though insensible to pain. When death occurs from the inhalation of ether it is the result of arrested respiration rather than its effect upon the heart, which is shown by the fact. that the pulse will continue for some time after respiration has been wholly arrested. Its effects upon respiration are produced slowly and are wholly observable, so that there is more warning than is the case with chloroform. On this ac¬ count, ether is a much safer anesthetic, and is rapidly replacing chlo¬ roform for this purpose. It is important to recollect that both ether and its vapor are highly combustible, as also that, being heavier than air, it will sink to the floor. A light held two or three feet above a sponge saturated with ether will not occasion any very great degree of danger, while the op¬ posite would be the case if it were held below. In an atmosphere highly impregnated with the vapor of ether, a flame will sometimes flash to a sponge lying several feet from the lamp or gas-jet. NITROUS OXIDE. 757 Some years ago, a dentist who was operating upon the mouth of a patient was suddenly horrified at seeing the patient’s breath take fire. The flames were soon extinguished, but not without some in¬ jury to the face and mouth of the patient. Dr. B. W. Richardson has called attention to the astonishing1 fact that in various parts of Ireland, particularly in Dublin, Cork, Belfast, and several other cities, together with a number of small villages in the “ Mountains of the North,” ether has been substituted for alcohol as an intoxicant. In one small place, known as Draperstown, ether is regularly sold in groceries and other small retail stores. The effects of ether-drink¬ ing are similar to those of alcoholic intoxication except that the effects are much more evanescent, a person becoming sober in an hour or two after having been hi a state of intoxication which, if induced by alcohol, would have required several hours to recover from. The quantity usually taken is from half an ounce to three ounces. The breath of those who employ ether as a drink is for some time so heavily charged with the vapor as to be inflammable. The story is related, on reliable authority, of a man who, after drinking ether, lighted his pipe to smoke, and in doing so also set fire to his breath, a volume of flame issuing from his mouth. He would certainly have died had it not been for the assistance of a friend who quickly threw him down and by pour¬ ing water into his mouth extinguished the flames before any fatal injury had been inflicted. Nitrous Oxide is a colorless, almost odorless, gas of sweetish taste. It is made by the distillation of nitrate of ammonia. Its use as an anesthetic exceeds that of any and all other anesthetics together, as it has for a number of years been employed very largely by dentists in the extraction of teeth. It is only fit for use in such minor operations as tooth extraction, the opening of felons and abscesses, and similar opera¬ tions. Its anesthetic effects have, by recent experiments, been found to be wholly due to depriving the bipod of oxygen, since similar anes¬ thetic effects are produced by the inhalation of pure nitrogen, hydrogen, or any other gas which will not support respiration. The exciting and exhilarating effects which frequently accompany its use are thought to be due to a specific influence of the gas. There is some evidence, how¬ ever, that these effects may also be simply the result of the deprivation of oxygen. Its anesthetic effects are produced very rapidly, and are equally transient in duration, no unpleasant effects following its admin¬ istration. Its use is generally considered perfectly safe; but that this RATIONAL REMEDIES FOR DISEASE. 758 is not the < ’jiso is indicated by tlie fact that several deaths from its use have been recorded. The infrequency of deatli from its use is probably due to the short time required for the operations in which it is generally employed. Large quantities of this gas, and water impregnated with it, are sold under the name of “compound oxygen,” from which the most marvelous effects are said to be obtained. From information recently received we are satisfied that little good is accomplished by this agent. Bi-chloride of methyl is closely allied to chloroform in character, as its use is attended with the same danger. It has been little employed, and probably will never come into general use. Depresso-Jlotors, — The drugs of this class are so called because they lessen the activity of the spinal cord. The principal drugs which have this effect are calabar bean, bromides of 'potassium, sodium, am¬ monium, and lithium, chloral and bromal hydrates, nitrate of amyl, lobelia, gelsemium, tobacco, and couium. Calabar bea u contains an alkaloid called physostigma, to which its j»oisonous properties are due. In fatal doses it produces death by paraly- is of respiration, which is undoubtedly due to its poisonous effect on the nerve-centers. One of its most pecu liar effects is to cause contrac¬ tion of tin; pupil, for which reason it is frequently useful in the treat¬ ment of affections of the eye and to counteract the dilating effect of b<4Uulonna. The bromides of potash, sodium, ammonium, and lithium, have also a depressing effect on the spinal cord, on which account they are very largely used in the treatment of nervous diseases, particularly epi¬ lepsy. IVobably there is no drug which has so powerful an influence upon the disease mentioned as bromide of potassium. It will undoubt¬ edly check tin; epileptic convulsions, and numerous cases are recorded in which the occurrence of convulsions has ceased after the long-continued use of this drug. We have used it in quite a number of cases of this disease, but our experience has been that, employed alone, it is a very un¬ satisfactory remedy, and will rarely secure anything more than tempo¬ rary relief. In addition to this it must be said that it is a powerful irri¬ tant to the stomach, often occasioning serious disturbances of the dmes- tion, and so operating directly against those measures which must be the most permanently useful in securing recovery from the disease. As we shall show elsewhere, epilepsy may be successfully treated without the use of bromide of potassium, which, when employed in such a manner as to occasion irritation of the stomach, really does more harm than good. HYDRATE Of1 CHLORAL. 750 The drug may be sometimes useful in interrupting the paroxysms of the disease, but it should not be depended upon as a curative agent, since a cure can only be brought about by improving the nutrition and re¬ inforcing the vital energies of the system ; and the almost universal con- nection of some degree of impairment of the digestion with epilepsy is a strong argument against the very common use of bromides. Hydrate of Chloral is a drug which has come to be used within the last three years, and has been most extensively abused. Like the other drugs of this class it has a powerfully depressing influence upon the cen¬ tral nervous system, by means of which it produces a tendency to sleep. Sleep under the influence of chloral, however, is by no means identical with natural sleep. In the latter condition the brain contains very little blood, being pale and anemic, as a result of which there is complete rest, at least of the cerebrum and higher nerve-centers of the brain, while in the sleep under the influence of chloral the blood-vessels of the brain, as well as of other parts of the nervous system, are dilated and gorged with blood, a condition similar to that produced by alcohol in nar¬ cotic doses. So great an amount of harm has been done by the use of this drug that we think the world would have been better off had it never been discovered. Dr. Richardson, as well as other ob¬ servers, has shown that its employment for its narcotic effects since its discovery, scarcely ten years ago, has become very extensive. There are now, especially in large cities, many persons who take chloral in enormous doses as habitually as alcohol and opium are taken. Its effects on the system are in the highest degree pernicious. It produces changes in the blood similar to those which are found in scurvy, produ¬ cing, in fact, nearly all the other symptoms of that disease. The long- continued use of chloral as a medicine produces effects not dissimilar to those occasioned by its non-medicinal habitual use. We regard it as a poisonous drug which could very well be dispensed with. We have rarely found any occasion for its use, being usually able to substitute some better remedy in cases in which it is supposed to be indicated. As a local application, however, we have frequently found it useful where the object is to cause the absorption of morbid tissue and to lessen too profuse secretion, as in some cases of inflammation of the pharynx. Its use as a gargle has also been highly recommended in diphtheria. Nitrite of Amyl is a volatile liquid with a peculiar odor. It is pre¬ pared from fusel-oil. On account of its great volatility it is chiefly used in inhalation. Its effect is to produce great fullness and distension of the 760 RATIONAL REMEDIES FOR DISEASE. blood-vessels of the head, accompanied with severe pain, flushing of the face, and difficult respiration, with violent action of the heart when any¬ thing more than very small doses are inhaled. It also has the peculiar effect to cause surrounding objects to look yellow to a person under its influence. One of the most marked effects of this drug is to destroy the power of the blood corpuscles to absorb oxygen. On this account its in¬ halation produces a distinct feeling of threatened suffocation. The only cases in which we have found the drug of any use has been in relieving the paroxysms of obstinate cases of asthma until the effects of other rem¬ edies could be secured, and in preventing epileptic convulsions. It should be taken with very great care, only a few drops being placed on a hand¬ kerchief and inhaled for a minute or two. It should be remarked that the full effects are not felt until a minute or two after it has been with¬ drawn. It is certainly sometimes very useful in interrupting the con¬ tinued convulsions present in what is termed the status epilepticus, in which the paroxysms often follow each other in rapid succession. We have had patients under treatment who carried a small vial of the drug constantly with them, and whenever they felt the premonitory symp¬ toms of the paroxysm, by holding the bottle to the nose and taking a few deep inspirations, were enabled to prevent the occurrence of any further symptoms. It, of course, has no curative value, but it must be acknowl¬ edged to be of some real service in such cases. In all cases which were relieved in this way which we have had under treatment, resort to the drug was found unnecessary after the first two or three weeks. Lobelia. — This common drug, made familiar by its almost universal employment, by Thompsonian doctors and physio-medical physicians, produces in both man and animals the most intense prostration, which is usually indicated by feeble pulse, cold sweats, great relaxation of the muscles, and emesis. Many cases of fatal poisoning have been produced by it. Its general effects are, in fact, almost identical with those of to¬ bacco. It was formerly much employed for its relaxing effects in whooping-cough, epilepsy, and tetanus, but it has been generally aban¬ doned in the treatment of those affections, as much less dangerous rem¬ edies have been found to be equally, or more, efficient. Tobacco. — The effects of tobacco upon the human system have al¬ ready been so fully described that we do not need to notice this drug at length in this connection except to say that its poisonous effects are so rapid and powerful, that, although formerly much employed, it is now very seldom used. About the only useful service which it can perform ALTERATIVES. 7G1 is in the destruction of vermin, but its use for this purpose must be con¬ demned, since numerous cases of fatal poisoning have occurred even from its employment in this manner. Gelscmium. — This is an alkaloid whose poisonous character has been well shown by its fatal effects, as small a quantity as one-sixth of a grain having proved fatal to a man. When taken in anything more than the smallest doses, it produces dilatation of the pupil, dizziness, great weakness, and frequently double vision. Death, in poisoning, is produced by paralysis of the circulation. Alteratives. — This term is applied to drugs which, when taken into the system, occasion a change in the functions of various vital organs, by means of which the processes of nutrition are modified. In other words, they are supposed to alter the vital actions taking place in the body. The various medicines which are supposed to purify the blood, belong in this class. It is, however, in the highest degree probable that by their use, the opposite, rather than purification, takes place. It seems to us to be clearly evident that the so-called action of these drugs is wholly due to a modification of the vital processes occasioned by the ef¬ forts of the system to rid itself of the poisonous elements of which it can make no use. The principal drugs employed for alterative purposes are arsenic and its preparations, mercury in numerous forms, iodine in various combinations, cod-liver oil, phosphoric acid and phosphates, colchicum, sarsaparilla, sassafras, and dandelion. Most of these drugs are so largely used that it will be worth while for us to give each some attention. Arsenic. — The drug known by this name is a compound of metallic arsenic, or arsenicum, with oxygen, called white arsenic, or arsenious acid. When thrown upon hot iron, it volatilizes with a peculiar, gar¬ licky odor. It is an exceedingly active poison, and even when largely diluted with water it is a severe irritant. When swallowed in consider¬ able quantities, it produces intense inflammation of the digestive organs, and speedy death. When smaller doses are taken, death may not occur for two or three days. If the body is examined after death in the latter class of cases, in addition to the irritating effects of the poison upon the mucous membrane, with which it comes in contact, it is found that great changes have taken place in nearly all the tissues of the body, the muscles, liver, kidneys, and various other tissues having undergone what is termed fatty degeneration. When taken even in medicinal doses for 702 RATIONAL REMEDIES FOR DISEASE. skin diseases and other affections, for which it is usually prescribed, for a long time some of the same poisonous symptoms are occasioned, the more common of which are puffiness under the eyes, and sometimes dropsy, together with the appearance of albumen in the urine and casts, the well-known sign of acute inflammation of the kidneys. The especial effects upon the kidneys are probably due to the fact that the poison is chiefly eliminated by these organs, as it can be detected in the urine in a very short time after its administration. The most common uses of arsenic are in obstinate cases of ague, inveterate skin diseases, dyspepsia, and nervous disorders. In view of its* exceedingly poisonous effects, even when taken in medicinal doses for some time, it seems to us that its use as a medicine is quite unjustifiable. . There are many eminent physicians who do not recognize its supposed utility as a remedy for skin diseases. In the treatment of nervous diseases it certainly cannot in any degree compare with electricity, which is wholly devoid of the dangers attendant upon the misuse, or even the use, of this drug. Mercury. — This drug, once known as the “ Samson ” of the materia medica, is now much less used than formerly. It is a powerful mineral poison in all its combinations, being most rapidly fatal even in small doses in the form known as corrosive sublimate. The first symptoms of mercurial poisoning, when it has been taken into the system, are seen in the mouth, consisting of a fetor in the breath, and soreness of the teeth. Very soon the patient discovers a metallic taste, the gums become swollen and soft, and bleed profusely on very slight abrasion, accompanied with a profuse flow of saliva. If the use of the drug is persisted in, the gums become swollen and inflamed, and marked by a red line at the junction of the teeth. The tongue also becomes swollen, sometimes enormously, protruding from the mouth so as to prevent its closing. The teeth become loosened in their sockets. The saliva is in¬ creased in quantity, becomes ropy and viscid, and pours out over the swollen and lacerated lips. The whole system is feverish. This condition of things often becomes worse, so that the teeth fall out of their sockets. Large portions of the gums and cheeks slough away, leaving the patient scarred and disfigured for life. The jaw-bones undergo necrosis, large portions separating and coming away after long periods of suppuration. The blood becomes thin and deficient in red corpuscles, and contains large quantities of fetid fatty matter. Epilepsy, insanity, scurvy, pa¬ ralysis, resembling that from lead-poisoning, and necrosis of the bones in various parts of the body, are the well-known results of the use of mercury. MERCURY. 763 The old-fashioned treatment of fevers by mercury has been almost wholly abandoned, and there seems to be an increasing and wholesome inclination to substitute for it less harmful remedies. The experiments of Dr. Bennett in Edinburgh, and of a number of other careful ob¬ servers, have shown that the belief in the efficacy of mercury as a cholagogue, or liver stimulant, has been entirely a mistake; in fact, the results of a large number of experiments show that instead of increasing the amount of bile secreted by the liver, the quantity is actually de¬ creased when mercury is taken. It is true that a large dose of mercury will occasion the appearance in the bowel discharges of a considerable quantity of bile; but as Dr. Chambers very pertinently remarks in ex¬ planation of this phenomenon, this is simply due to the fact that the bile has been so poisoned by the mercury administered that it cannot be absorbed and used in the system, and hence is discharged. It should be borne in mind that the bile is a secretion as well as an excretion, and that the larger share of this fluid secreted is taken up with the food, the absorption of which it greatly promotes, and is used in the system, only the waste and excrementitious products being allowed to escape with the detritus of the food. The effect of the mercury is to so change the composition or qualities of the bile as to render it useless and unfit for absorption, consequently that which should be taken up in the system is lost and carried away with the useless elements of the food. In view of these facts we are forced to the conclusion that the use of mercury to relieve congestion and tor¬ pidity of the liver, or conditions which have often been termed “ bil¬ iousness,” has been a great mistake. Facts indeed show that mercury is one of the most active agents in producing torpid and inactive livers. Indeed, it is our candid opinion that the liver of a person who has been salivated a few times is maimed for life. One of the peculiarities of mercury is that when taken into the system it is very frequently de¬ posited in various tissues, and there retained for a long series of years. It is probable that the liver thus contains a considerable proportion of the mercury which is received into the system, partly since it first re¬ ceives the drug through the medium of the portal vein, after it has been absorbed, partly on account of the well-known fact that it pos¬ sesses the peculiar property of retaining within its tissues various me¬ tallic substances, such as lead, copper, and arsenic, as well as mercury. It is for this reason that the chemist, in searching for evidences of death from metallic poisoning, is anxious to secure the liver for TGI RATIONAL REMEDIES FOR DISEASE. examination, particularly if there is suspicion that the poisoning has been effected by a slow and somewhat long-continued process. It is also stated by authority which we have good reason to consider re¬ liable, that mercury has in some instances been found in the bones in a metallic state. It is said that an Italian professor once astonished his students by striking his lecture-desk with the bone of a human being and thereby causing countless numbers of minute globules of mercury to roll out upon the table. During life the patient had taken considerable quantities of mercury for a long time, and it seems that the metallic element had been stored up in the bones in such quanti¬ ties that it could be shaken out in a metallic state after death. The fact that mercury has some particular affinity for the bones may be inferred from the statement of Prof. Gross, in his great work on sur¬ gery, in which, in speaking of syphilis as a cause of necrosis, he states that “ the history of this disease has shown that the osteitis growing out of it is more apt to occasion death of the bone when the patient has been subjected to three courses of mercury for his cure than when the malady has been treated on general antiphlogistic principles.” The quotation from Prof. Gross also brings to light another fact of very great importance, namely, that in syphilis, one of the diseases in which mercury has been considered by many as a real specific and ab¬ solutely essential to recovery, it is by no means so useful or harmless as its advocates have generally supposed. It is an omen of good that at the present time numerous physicians, many of much eminence, are beginning to entertain serious doubts of the efficacy of mercury in the treatment of these diseases also ; and we should not be at all surprised if within the next ten years this, the so-called “ Samson ” of the ma¬ teria medica, should be reduced in the eyes of practitioners, at least, to the proportions of a dwarf, if it is not annihilated altogether, which in our opinion would not be a serious detriment to the world, since all possible advantages sacrificed would be much more than counterbal¬ anced by the damage which would be obviated. Dr. Wood has stated on this point, “ There has arisen a school of syphilographers [physicians devoted to the treatment of syphilis] who assert that the drug is not only not necessary, but is in all stages and all cases of the disease most injurious; that the worst symptoms of the disease are due, not to the constitutional affection, but to the remedy given for its relief.” Although never having made a specialty of the disease in question, we have treated a sufficient number of cases to demonstrate to our satis- MERCURY. 765 faction that the views entertained by the class of specialists referred to are entirely correct. We were glad to notice not long since an able article in the British Medical Journal, the author of which maintained that syphilis could be much more successfully treated without mer¬ cury than with. The opinions of the author are entitled to some con¬ sideration, for his position is Surgeon of Militia in the Medical Corps of the British army, and Assistant Professor of Pathology in the Army and Medical School at Netly. The article referred to was an abstract of a paper read by him before the meeting of the British Medical As¬ sociation in 1878. He cites hundreds of cases of syphilis successfully treated by him in all stages of the disease wholly without the use of mercury. He says distinctly, “ The practice which in the main guided me in the treatment of syphilis was the practice of avoiding mercury as much as possible. My sheet-anchor has in all cases been the fre¬ quent employment of hot-water baths.” He suggests to those “ who hold that the specific action of mercury is absolutely necessary for the eradication of syphilis from the organism, to consult the works of Hughes, Bennet, Lancereaux, etc., for a list of observers, committees, or councils, that have declared in favor of the same treatment of syph¬ ilis.” The facts as shown by a large and increasing number of ob¬ servers with reference to this disease have proven that the use of mer¬ cury simply checks or obscures the symptoms of the disease. What is needed to effect a cure of this terrible malady, so far as a cure can be effected, is to aid nature in the process of eliminating the virile poi¬ son with which the system of those suffering from the disease is contam¬ inated. A drug which exercises upon the system such a powerfully depressing and poisonous influence as mercury can certainly render no assistance in this process. In fact, it diverts the attention of the life forces from the syphilitic poison to the mercurial poison, and in so do¬ ing checks the remedial process which nature sets up, and thus while checking the manifestations and symptoms of the disease, and so af¬ fording a false feeling of security on the part of the sufferer, only hides the malady, and postpones to a later period the terrible punishment which these sufferers must almost certainly undergo, and renders al¬ most certain its subsequent outbreak with greatly increased virulency, if not in the life of the individual himself, in that of his posterity. As we have elsewhere shown that there is a much more rational method of treating this disease, we need not delay further on the sub¬ ject in this connection. Before leaving the subject of mercury we 700 RATIONAL REMEDIES FOR DISEASE. should mention another fact which ought to he generally known, though we think it is not mentioned in works on poisons, that calomel, one of the mildest forms in which mercury is administered, if taken into the stomach in connection with chloride of sodium, or common salt, may, through chemical reaction with the salt, be converted into corrosive sublimate, a much more powerful poison, and may produce serious and fatal consequences. Iodine. — Iodine in its pure state occurs in crystalline scales, with a bluish metallic lustre. It is quite volatile, having an odor similar to . that of chlorine, and a very hot and acrid taste. At a temperature a little above that of boiling water it melts, and is converted into a beau¬ tiful purple or violet vapor. It has the peculiar property of turning starch blue, which effect Is made of practical utility as a test for this drug. That iodine is a powerful poison is shown by the fact that when given in any but very small doses it produces the effects of poisoning, such as ringing in the ears, salivation, vomiting, diarrhea, cutaneous eruptions, and palpitation of the heart, with great loss of flesh, sleeplessness, hypochondria, etc. When its use is continued a long time, though in small quantities, it produces atrophy, or wasting, of certain glands of the body, such as the breasts in the female and the testicles in the male. On account of its effect in producing absorption of tissue, it is often used for the treatment of abnormally enlarged glands and other growths, sometimes with the effect to occasion their disappearance. Iodine is much used in the later forms of syphilis, in which disease immense doses of the drug are sometimes taken. We have seen persons who were taking an ounce of the drug a day. This usually produces a skin eruption, but certainly has the effect to stop the progress of the morbid action, as when rapid ulceration is taking place, as in ulceration of the throat and the internal structures of the nose. We believe the drug to be of real service in some of these cases, as well as in certain cases in which morbid growths of a syphilitic character have taken place in the brain and produced serious inter¬ ference with the functions of that organ. In numerous cases it has been shown that through the administration of iodide of potassium marked cases of this sort have been cured, and it has thus been the means of saving life. When taken internally to cause the absorption of such growths as goiter, it produces absorption of the other glands mentioned as well as of the abnormal growth. It generally happens, also, that after the use of the remedy is discontinued the growth re- PHOSPHORIC ACID. 707 turns, but the natural glands which have been affected by it do not gain in size. Iodine is also of service in the treatment of some surgical cases, as hydrocele, cases of pleurisy in which effusion has taken place, and for injections into cavities from which pus has been drawn, to prevent its re-formation. Iodide of potash is said to be useful in chronic rheumatism and gout, but we have never seen any good from its use, and believe that these diseases can be treated far more successfully without it, as we have proven in numerous instances. Iodoform, a drug which is prepared by the action of iodine upon chloroform, has recently come into use to some extent, and from the opportunity we have had of testing it we think it to be a very useful agent. When sprinkled upon foul ulcers it has the effect to cleanse them, and so modifies their action as to enable healthy granulations to form and healing to take place. In cancer of the uterus, chronic uterine inflammation, and some other affections occurring in this region in females, we have found it very useful in relieving pain, correcting fetor, and apparently inducing a healthy action. We have found it useful also in relieving painful maladies where the patient was not willing to submit to an operation for a radical cure. Cod-Liver Oil also has been much praised as an alterative, but there is a great difference of opinion respecting its virtues. To the majority of persons it is nauseating, is frequently ejected from the stomach, and often causes indigestion together with looseness of the bowels. It is disposed of by the digestive organs with great difficulty, which ac¬ counts for these effects. We prefer to prescribe for persons who re¬ quire fatty matter in addition to what they receive with their food, sweet cream, which is the most easily assimilated of all forms of fat. Cod-liver oil has received much praise as a remedy for consumption on account of its supposed alterative effects, but it seems to us to be clearly proven that any other fat that can be easily assimilated can take its place without detriment whenever fatty elements are needed. Phosphoric Acid is a product which results from the burning of phosphorus in the air. It has also been much praised as an altera¬ tive. It is sometimes used in solution in the pure state, but more often in the form of what are termed phosphates, particularly phosphate of calcium. Many preparations of phosphates are offered for sale by druggists under a great variety of names, as “ chemical food,” 70S RATIOXAL REMEDIES EOP. DISEASE. ~ compound syrup of phosphates, "phosphate of lime/' etc. There - -t> been much discussion as to the possibility of the ass India - tion of the thosphate of lime and other phosphates artificially pre¬ pared. Some very eminent physicians express the decided opinion that verr little if any <;f the preparations of phosphorus artificially ma ie are assimilate! when taken into the stomach. Ha.jar, an emi¬ nent German physician, claims to have shown this to be the case with rhosphate :t calcium, which is considered the most important and is the mist freely employed of all Applying the well-known principle of physiology, that animals can assimilate only organized matter, the assimilation t m manic matter heint: c: tinned wholly to vegetables, there would seem to he no Ilthcnlty in settling the question of the asshmilati :n of artificially prepared phosphates. There are many per¬ sons however, who claim that the phosphates of lime. iron, and a few other mineral substances are exceptions to the general rule, though they offer no proof that snch is the case. The arguments against this theory are very strong, and. in ieed. they seem to us to be unanswera- "tle. mav - snmmt rim- . -as t — 1. The fait that in ah of those cases in which phosphates are sup¬ pose! to re nee lei. the urine is loaded with phosphates, shows very clearly that the dim unity is not a deficiency in the supply of phos- 7 hates in the system, but a deficient assimilation or continued loss of these elements. 2 An a nr iart supply of phosphates is furnished in the food, and in a condition of such intimate combination with the other elements of food that absorption must take place with readiness. The amount of phosphates administered in the conditions supposed to require them is wholly made rate to supply the requirements of the system. In¬ deed. when compared with the amount fumishei in ordinary food, it is entirely insignificant. The most liberal prescription of phosphates would not exceed thirty or forty grains a day. while the amount of the salts taken in the food in a single dav is about ten times as much. If the diet consisted entirely of oatmeah 340 grains of the salts would be taken in one day. A proportionate uantity of meat would con¬ tain 37-i grains of the salts, while an e .ui valent amount of potatoes would fumish to the system 434 grains. — more than ten times the maximum amount of phosphates ever administered. But Dr Birger, of London, asserts that not more than three to six grains of the arti¬ ficial iy tt-tarei lime salts can be absorbed in twenty -four hours. PHOSPHORIC ACID. 769 consequently, the greater share of what ls administered in ordinary medicinal doses is wasted, and the comparison between the amount which can be received into the system as medicine, and the amount which can be received as food, becomes still more striking, the pro¬ portion being, according to this statement, one part of the artificial salts to from fiftv to one hundred and fiftv of the organic salts found • * ^ in the food. This view of the case certainly puts the matter in a somewhat ridiculous light, for it could not l*e considered any possible advantage to administer as a food, with a view to supplying a special want of the system, a substance which was already leing received in quantities more than one hundred times as great. 3. Experiments which have teen made with the use of these salts furnish evidence that even so small an amount as that stated by Dr. Banger is not absorbed. The principal evidence is that the amount of phosphates discharged in the urine is not at all increased by their ad¬ ministration. even though larse quantities are given This observa¬ tion still further confirms the supposition that in cases in which the phosphates are wanting in the tissues the difficulty is faulty assimila¬ tion rather than a deficient supply, at lea^t in a great majority of cases. It may be further objected to the common use of phosphates that they are injurious on account of their interference with the func¬ tions of -digestion. This serious influence of phosphates upjn digestion is so well recognized that eminent writers upon therapeutics give warning against their too frequent use. It should l:e also stated that when used in the large quantities in which they are frequently taken they sometimes form concretions in the lowed . and so occasion seldom injury. The only argument in favor of the use of phosphates is that their use seems to be followed in many cases by improvement in the condi¬ tions for which they are administered, whether they are remedial or not. It may be said in answer to this argument, in this case as in the case of many other drugs, that it must be very difficult to decide- whether the improvement observed as the result of the phosphates is independent of them, or is in spite of them. Those who contend that phosphates are not absorbed in the blood at all or in so small a degree as to produce wholly inappreciable effects, ascribe the benefit which >eems to follow their Use to the improved hyinene which is, or at least should be. in all cases prescribed with them. In the experiments of French physiologists it was found that animals died when fed upon food which had been deprived of its natural salt'. 49 770 RATIONAL REMEDIES FOR DISEASE. Colcllicum. — This drug is obtained from the roots and seeds of the meadow saffron, a small plant growing in Europe. The preparation usually employed is what is known as the wine of colchicum, prepared from the root. This drug is usually considered to be a specific for .gout, for which it is more used than for any other purpose. There is no doubt that when taken by persons suffering with attacks of gout it will frequently relieve painful symptoms in a very short time. That it does not cure gout, however, is sufficiently evidenced by the fact that thousands of people continue to suffer from it notwithstanding their continued use of colchicum. If it were a specific, it should effect a cure instead of mere palliation. It was formerly supposed that colchicum afforded relief from the gout by exciting the kidneys to in¬ creased elimination of uric acid. There have been, however, so many observations by competent observers showing that the drug has no such effect, rather diminishing than increasing the amount of uric acid contained in the urine, that the so-called action of the drug can no longer be explained by this theory. Dr. Ringer, in his celebrated work on therapeutics, says that colchicum does not in any way affect the condition on which gout depends, and hence “ is merely a palliative, re¬ moving for the time the patient’s suffering, but, as experience abun¬ dantly proves, in no way protecting him from a recurrence of the at¬ tack ; for it is on all hands accepted that colchicum is inoperative to prevent the return of the attack ; nay, many who suffer from it are of the opinion that while the medicine removes altogether the existing attack it insures the speedy return of another. Hence, gout-ridden people generally advise their fellow-sufferers to abstain from the use of colchicum.” It is a very irritating drug, and when taken in any but small quantities, produces the most violent irritation of the mucous mem¬ brane. It has been used in rheumatism as well as gout, especially in the chronic form, but there is still less evidence of its utility in this disease than in gout. We see no reason for its employment when there are other remedies, the superior efficacy of which is so well ad¬ mitted, as elsewhere shown. Sarsaparilla. — This much-used drug is the root of smilax, a little vine native of Mexico and northern portions of South America. It has been long and widely used as a “ blood-purifier ” in scrofula, syph¬ ilis, and other diseases in which the blood has been supposed to require purification. It also at one time enjoyed great reputation as a remedy LOCAL REMEDIES. 771 for cancer. Very extensive investigations respecting its effect upon the system have shown, however, that its medical properties are very slight indeed, if it is not entirely neutral. The only effects which fol¬ low very large doses of a decoction of the root are slight disturbances of the stomach. It has been supposed to excite the action of the kid¬ neys and skin, but experiments show that this is not the case ; and, so far as scientific evidence goes, the probability seems to be that it is wholly destitute of medicinal properties. It is claimed, however, not¬ withstanding the negative results obtained by experiment, that its use in the treatment of such diseases as chronic syphilis and scrofula in¬ dicates that in some mysterious way it favorably affects the system in these morbid conditions. But from all that we have been able to learn of its effects even in these diseases, it seems to us very prob¬ able that the beneficial results obtained when it has been employed alone, in such a way as to afford an opportunity of judging of its ef¬ fects, have been due either to the absence of powerful and depressing drugs, to improved hygiene, or to the vis medicatrix naturae. Sassafras, Taraxacum, etc. — The bark from the root of the sassa¬ fras tree, the root of the common dandelion, and quite a number of other common barks and roots, are popularly supposed to possess al¬ terative properties. For this purpose they are very largely used. The evidence of any such fact is, however, of an exceedingly doubt¬ ful character. Prof. Wood, of Philadelphia, in his “ Materia Medica,” says with reference to dandelion that “ no effect is to be witnessed from a single dose of the drug however large, other at least than some nausea.” With reference to the diuretic properties which this drug is popularly supposed to possess, he says, “ The only evidence brought for¬ ward to establish this is the vulgar name which the plant bears both in English and in French.” Perhaps the best that can be said of these drugs is that they would not be likely to do any very great harm, al¬ though only an equal amount of benefit can be expected from them. LOCAL REMEDIES. The drugs thus far mentioned are those which are supposed to oc¬ casion systemic effects. We will now consider in a somewhat brief manner the particular drugs to which are attributed local effects. Astringents. — Astringents are of two classes, — vegetable and min¬ eral. Vegetable astringents comprise ta,nnic and gallic acids, oak RATIONAL REMEDIES FOR DISEASE. 772 bark, rose, geranium, blackberry root, persimmon, etc. Mineral as¬ tringents comprise the alums, sulphate of aluminum, various com¬ pounds of lead, bismuth and its preparations, zinc and its compounds, cadmium, copper, silver, and other preparations. These drugs are called astringents because when applied to living tissues they occasion contraction. This has by some been supposed to be due to the coagulation of albumen ; by others, to the contraction of the muscular fibres ; but facts do not seem to support either theory. No doubt the real truth is, in this case as in the case of the other drugs, the action of which we have examined, that whatever action is exerted takes place upon the part of the living tissues and not upon the part of the agent employed to produce the action, the peculiar character of the action in different cases being wholly due to the dif¬ ferent ways in which various agents are recognized by the tissues. The essential element in all vegetable astringents is tannic acid. It occurs as a light, feathery powder of a light yellowish color and some¬ what bitter taste. When absolutely pure, however, it is colorless and free from all odor and taste other than that of astringency. It dissolves readily in water, but is still more freely soluble in glycerine. It combines with various vegetable alkaloids, which makes it a very useful agent in cases of poisoning from morphia, strychnia, and all the other poisonous alkaloids. When combined with iron it forms a black compound, to which is due its utility in the manufacture of ink. It coagulates white of egg, or albumen in any other form, on account of which it cannot be absorbed into the blood in any appreciable quantity. As the effects of tannic and gallic acids, and various substances which contain them, are entirely local, they are very useful agents in treating a variety of morbid conditions. For example, they may be used to cause contraction of the tissues in spongy gums, in hemorrhoids, in chronic sore throat, or pharyngitis, in which the tissues are very much relaxed and the blood-vessels dilated. Tannic acid is also useful in the treatment of hemorrhage when the source of bleeding cannot be reached, as in hematemesis, or bloody vomiting, hemorrhage from the bowels, etc. It is used to diminish morbid secretions, as in diarrhea, chronic looseness of the bowels, excessive sweating, and various diseases of the skin. It is also very properly used, often with marked benefit, for the purpose of hardening parts which are exposed to friction or pressure, as the under parts of the body in patients who are long confined in bed and unable to move themselves. It is very largely and usefully employed in the treatment of many local diseases peculiar to women. Tannic acid is one of the best remedies for poisoning with tartar emetic, as it forms with the antimony an insoluble compound. When it is to be administered internally it should be given in doses of from three to five grains, either in pills or in capsules. When its astringent properties are desired to act on the intestines, or when given for hem¬ orrhage from the stomach, it should be*in a powder in doses of from ten to twenty grains. For external application the best preparation is a so¬ lution of tannin in glycerine, in the proportion of one part of tannin to four of glycerine. This may be applied as required for the purpose of lessening seci*etion, as in leuchorrhea and chronic ulcers. A decoction of the bark of the white and black oaks is often used as an astringent for O external local applications, but their efficacy is wholly due to the tannic acid which thev contain. %/ Alum. — There are two varieties of alum used in medicine, potash alum, and ammonia alum. The latter, being cheaper, is the most com¬ mon. Their properties are identical. What is known as burnt alum is the white powder obtained by heating the drug until the water of crystallization which it contains is driven off. It is soluble in either form in very cold water. When applied to the tissues it acts as a very powerful astringent and irritant. This property is illustrated by its effect upon the mucous membrane of the mouth, with which every one is familiar. It may be used with good effect to arrest slight hem¬ orrhage when the seat of the hemorrhage can be reached. In cases of bleeding from the lungs, a saturated solution should be inhaled by means of an atomizer. It is very frequently used for mouth-washes and for gargles for sore throat, but it should never be thus employed, as it has a very destructive action on the teeth. Sponging with alum-water is a very useful means of arresting the night-sweats of consumptives. It may also be usefully employed in the treatment of chronic ulcers. In the form of burnt alum it is particularly beneficial in those cases in which granulations are exuberant. It is also a good antidote in lead poisoning before the lead salt has been formed, as it precipitates the lead in an insoluble form. Sulphate of aluminum has similar properties to those of alum. Lead. — The soluble compounds of lead in weak solution are quite powerful astringents, and hence they may be usefully employed as ex¬ ternal applications, if better means are not at hand. All the soluble 774 RATIONAL REMEDIES FOR DISEASE. compounds of lead are, however, exceedingly poisonous in character, and poisoning from their reception into the system is the most common of all forms of poisoning. Lead poisoning occurs most frequently in those whose occupation exposes them to its influence, as persons engaged in the manufacture of white lead, painters, and other laborers wTho employ it largely in their work. Poisoning also occurs very frequently through the medium of water which is contaminated by passing through lead pipes, or by standing in lead-lined tanks. Food is also frequently con¬ taminated in the same manner by cooking in tin-lined vessels, in which the tin is adulterated with lead, or by standing in vessels made of the same kind of tin, as in the case of milk. There is good evidence for be¬ lieving, also, that poisoning not infrequently occurs from the use of fruits and vegetables which have been put up in tin cans made of lead tin. Cases have been observed, also, in which lead poisoning has oc¬ curred from cooking in certain kinds of enameled vessels, in which lead was used in the enamel. The effects of lead poisoning are not infre¬ quently seen as the result of the use of cosmetics and hair-dyes, which very frequently contain the salts of this metal. We have met several instances of this sort in which the effects were very severe. The symp¬ toms of lead poisoning and its proper treatment will be described elsewhere. The symptoms of chronic lead poisoning are generally as follows: The patient first has slight colicky pains, which after some days increase in intensity, being sometimes dull, at other times sharp. They are gen¬ erally located around the umbilicus, often accompanied with severe retch¬ ing and vomiting. The bowels are costive, the tongue has a white coat, there is great thirst, and usually no appetite. Sometimes there is also severe headache with delirium and occasionally convulsions, similar to those noticed in epilepsy. One of the most common effects on the nervous system is paralysis of the extensor muscles of the fore-arm which allows the wrist to drop, whence it is known as “ wrist-drop.” Persons some¬ times become cross-eyed under the influence of the drug, from paralysis of the external rectus muscle of the eye. One of the most characteristic symptoms, and one which is always looked for, is a blue line on the edge of the gums where they join the teeth, which is almost invariably found in cases of lead poisoning. The best remedies for lead poisoning with which we are acquainted are the Turkish and electro- thermal baths, the latter of which is found to be particularly advantageous, especially when the primary or galvanic current is employed. By means of elec- EMETICS. ( to tricity, all of the indications for treatment are met: First, the poison is eliminated from the system by the eliminative effect of the warm bath, and the electrolytic effect of the electricity; second, the paralysis result¬ ing from the disease is relieved, and most successfully treated, by this means, as the exhausted vital forces of the patient are re-invigorated by this powerful tonic. Nitrate of lead is an excellent disinfectant. Bismuth, by which is understood the sub-nitrate or sub-carbonate,, is much used in vomiting due to an irritable condition of the stomach in neuralgia and cancer of the stomach, in pyrosis, or water-brash, in acute and chronic diarrhea, and in various other complaints. Though often used in very large doses with apparently no injurious effect, the use of this drug is sometimes followed by the most poisonous and even fatal results, which are supposed to be due to the compounds of arsenic which it is very apt to contain. Of the other metallic astringents, sulphate of copper and nitrate of silver are the most useful. They may frequently be employed with signal service in the treatment of chronic and obstinate ulcerated sur- © faces. Emetics. — This class includes all substances which, when admin¬ istered by the stomach or otherwise, induce vomiting. The mechanism of vomiting has been elsewhere described. © The principal drugs employed for the purpose of inducing vomit¬ ing are ipecacuanha, apomorphia. mustard flour, tartar emetic, sul¬ phate of zinc, and common salt. Ipecacuanha. — The ordinary dose of ipecacuanha is from five to thirty grains every fifteen to thirty minutes, administered in a powder. A smaller dose should be used for children. The most pleasant form for administration is the syrup, of which an emetic dose for a child is from one to two teaspoonfuls. Apomorphia is a drug prepared from morphia. This drug has the curious property of producing vomiting by the injection of an ex¬ ceedingly small quantity under the skin. The dose required is from one-fifteenth to one-tenth of a grain. Mustard Flour also is used as an emetic, especially in emergencies from narcotic poisoning. The required dose is a heaping dessert spoon¬ ful in half a pint of warm water repeated every ten or fifteen minutes, if vomiting does not occur. 776 RATIONAL REMEDIES FOR DISEASE. Tartar Emetic has been much used to produce nausea and vomit¬ ing. It is a very powerful drug, as the nausea produced by it remains for a long time and the vomiting is often violent. Its use is rarely, if ever, really necessary. Sulphate of Ziuc is much milder in its effects, as it occasions but little irritation. It may be given in doses of from twenty to thirty grains in cases of narcotic jDoisoning. Salt . — A teaspoonful of salt in a pint of warm water, followed by copious warm water drinking and tickling of the throat, is an excellent means of exciting vomiting. Copious warm water drinking and tick¬ ling of the throat with a feather or the linger will also aid the effect of other emetics and secure the desired result with smaller doses than would otherwise be required. We have known of several instances in which physicians have given one emetic after another without effect until nearly the whole list of emetic substances had been swallowed, relief being obtained only when the patient was directed to take copi¬ ous draughts of warm water. O Cathartics. — All drugs which occasion an increased activity of the bowels are termed cathartics, or purgatives. The effect produced by them is called purgation, or catharsis. The mode of action of cathar¬ tics has been the subject of much discussion. However their effects may be produced, they are in all cases due to the effort of the system to rid itself of the irritating and obnoxious substance employed. Pur¬ gative medicines are classified as follows : First, laxatives, which simply unload the bowels ; second, purges, which produce active purgation but do not act as poisons even in large quantities ; third, hydragogues, which cause large watery discharges without producing irritation even in large doses; fourth, drastics, which cause great irritation of the intestinal mucous membrane, and in large doses are violent poisons. ‘The principal laxatives employed are the following : — Laxative Food. — Bulky food, that is, that which contains a con¬ siderable proportion of innutritious matter in the form of cellular or woody tissue, produces free and loose discharges from the bowels, while ■concentrated food produces constipation. It is well known that car¬ nivorous animals, whose food is concentrated, are nearly always consti¬ pated, while the opposite is the case with herbivorous animals. So, also, line wheat flour, meats, and other concentrated articles of diet, produce constipation in man, while cracked wheat, graham flour, oat- CATHARTICS. 777 meal, Indian meal, and, in fact, the unbolted meal of all the grains, oc¬ casion a loose condition of the bowels. The same may be said of most acid fruits, as apples, pears, lemons, and particularly dried fruits. Milk is one of the most constipating of all articles of diet, a fact which renders it for some people an unwholesome article of food. Manna, the juice of the European ash, is a very gentle laxative when taken in large doses. It has a sweetish taste and is closely allied in its composition to sugar. For an adult, a dose of from half an ounce to two ounces is required to produce a laxative effect. For a child, four drachms should be taken in water. Carbonate of Magnesia is another very mild laxative. It is fre¬ quently employed by persons who habitually suffer with acid dyspep¬ sia, and is used as much to relieve acidity as for its laxative effects. It is taken in large doses of from half a drachm to half an ounce. This use of the drug, however, is often very injurious, since it not infre¬ quently accumulates in the intestines, causing large concreted masses. Sulphur is also very frequently used as a laxative, but it is much more commonly employed in certain skin diseases, particularly para¬ sitical diseases. It is a well-known remedy for scabies, the disease com¬ monly known as the “ itch.” It is also frequently used in the form of sulphur vapor, both in chronic rheumatism and other diseases in which it is thought to have an alterative effect. Not infrequently, however, when applied to the skin in the form of ointments it produces eruptions. By the above-named remedies a gentle action of the bowels may be induced, which is not usually followed by any unpleasant effects ; but when any vigorous action is desired, castor oil, rhubarb, senna, sulphate of magnesia, or Epsom salts, sulphate of sodium, Rochelle salt, jalap, colocynth, podophyllum, elaterium, gamboge, Croton oil, and a few other substances may be employed. Some of these produce a very violent action of the bowels with copious discharges, as is the case with Croton oil, while others operate much less severely. We give no directions for the use of these more powerful cathartics, since the in¬ jury which may result from their use is so great that the risk should never be incurred by non-professional persons. In our opinion, few classes of drugs are more abused than this. While there are cases in which the speedy and thorough action obtain¬ able by the use of cathartics is very useful, yet the habitual employ¬ ment of these powerful irritants to the digestive organs is attended RATIONAL REMEDIES FOR DISEASE. O / /» with the most disastrous results. When employed in the treatment of constipation they almost invariably aggravate the very condition which they are employed to remedy. When long continued, they with almost equal certainty produce serious impairment of the digestive or¬ gans. The very common practice of taking a dose of salts whenever there is irregularity of the bowels or a condition usually termed “ bil¬ iousness,” supposed to be due to the inactive condition of the liver, has a most pernicious effect. It will not be denied that in many cases the operation of the remedy is followed by apparent relief, and yet the relief is of the most temporary character and is generally obtained at the expense of the exaggeration of the very conditions which gave rise to the unpleasant symptoms in the first place. The popular supposition, common among physicians as well as non¬ professional persons, that cathartics give relief by increasing the activity of the liver, seems to be wholly without foundation, since it has been shown by a committee appointed to investigate the subject, with the em¬ inent Dr. Bennett of Edinburgh at its head, that cathartics have no in¬ fluence whatever to increase the activity of the liver, but, on the con¬ trary, diminish the amount of bile secreted. They undoubtedly often occasion an increased appearance of bile in the discharges, but this ap¬ pearance has been proven to be deceptive, and it has been clearly shown that the amount of bile secreted in twenty-four hours while the system is under the influence of a cathartic is actually less than is produced at other times. The only apology which can now be offered for the use of cathartics is that they produce a necessary depletion, which simply means that they destroy a portion of the person’s vitality, a fact which cannot be desirable under any circumstances, since what is needed in the treat¬ ment of disease and morbid conditions is the economizing and saving of vitality rather than its reckless waste. Fatal injury has often been done in the employment of cathartics for the relaxation of the bowels when intussusception or some other form of mechanical obstruction has been mistaken for simple constipation of the bowels. There is no doubt whatever but that violent cathartics may be wholly dispensed with in the treatment of disease, provided that the numerous other means of securing activity of the bowels are made use of, such as massage, copious water-drinking, the use of electricity, Swed¬ ish Movements, revulsive applications to the abdomen, stimulant applica¬ tions to the spine, etc. DIURETICS. 77 D The Enema. — For at least nineteen-twentieths of all ,the cases in which cathartics arc employed, warm-water enemata would fulfill all the conditions much better. With reference to the use of cathartics, Dr. Wood says that “ it cannot be doubted that the use of purgatives in such diseases as fevers and cholera, with the idea of eliminating some of the materies morbi, rests simply upon a crude, unproven, and probably false, pathology.’’ The same reasoning may be applied to the common use of cathartics as a means of purifying the blood. Perhaps the most useful service which can be derived from cathartic drugs is the removal of in¬ testinal parasites, particularly tape- worm and round- worms. For tape¬ worm they are useful by producing such violent contractions of the intestinal walls as to loosen the grasp of the worm, or, after it has been induced, to let go its hold, through the action of some other drug, to ex¬ pel it from the intestine before it has had time to renew its grasp upon the mucous membrane. Directions for their use for this purpose will be found under the head of “ Anthelmintics.” Diuretics. — The principal drugs represented to be useful for this purpose are squills, digitalis, sweet spirits of nitre, potash and its prep¬ arations, buchu, uva ursi, turpentine, cubebs, and cantharides. When taken into the system, these drugs are recognized by the kid¬ neys as elements which cannot be used and are likely to do harm, and so are removed by them as quickly as possible, by which means the amount of urine is largely increased. Incidentally, of course, urea and the other excrementitious principles found in the urine are also elimi¬ nated, but the principal object of the increased elimination of urine seems to be to get rid of the diuretic itself. Diuretics are used for five dis- tinct purposes : — First, in cases of functional inactivity of the kidneys, to stimulate thoseorgans to increased action for the purpose of eliminating urea and other poisonous elements which are naturally removed by the kidneys ; second, to remove superabundant fluids from the body, as in dropsy ; third, to diminish the irritating effects of morbid urine upon the bladder and other urinary organs, by increasing the quantity of urine by dilu¬ tion ; fourth, to apply medicines of supposed specific virtues to the blad¬ der and urinary passages in certain diseases of those parts ; fifth, to change the character of the urine in such a way as to prevent the formation of calculi. That all of these effects can be produced by the action of diuretics is unquestioned, since if it were not the case their use would have been 780 RATIONAL REMEDIES FOR DISEASE. abandoned loner aero. However, in connection with each one of these uses of diuretics there are several considerations of importance to which we invite attention. First, we will notice their effect in maintaining the action of the kidneys. The results obtained by the use of diuretics for this purpose are very uncertain. For instance, when the secretion of the kidneys is checked on account of intense congestion, it is evident that the adminis¬ tration of diuretics can be of no use. The kidneys already contain too much blood and have more work imposed upon them than they are able to perform, and to administer diuretics is to put upon them a still heav¬ ier burden and to render them still more incapable of performing their proper functions. The same remarks apply to the condition of the kid¬ neys found in acute inflammation. The delicate tubules with which these organs are filled, the purpose of which is to convey away the excre¬ tion, are in inflammation filled with the results of the inflammatory process so that the urine which is formed is dammed backed, and the organs thus become clogged. To increase the irritating qualities of the urine under these circumstances by the use of diuretics, cannot be other¬ wise than harmful. Yet, strangely enough, it is under these very con¬ ditions that diuretics are most often employed and persistently applied. The futility of such efforts has not infrequently been shown by the rapid improvement of the patient when the agents mentioned are dis¬ continued. Dr. Austin Flint, Sr., president of the Academy of Medicine in New York, reported to that body, a few years ago, a case of inflam¬ mation of the kidneys which occurred at Bellevue Hospital, in which, after the failure of all other means to produce a free evacuation of urine and when the case had been virtually abandoned, the patient was al¬ lowed to satisfy his desire for fluids by drinking as freely as he chose, with the result of producing immediate improvement in the symptoms. By a continuance of the same measure, which was encouraged when its good effects were seen, ultimate recovery was secured. Second, diuretics are much used for the purpose of causing absorp¬ tion of the liquid which has been accumulating in the tissues or in va¬ rious cavities of the body, as in abdominal dropsy, dropsy of the chest, and anasarca, or general dropsy. While temporary benefit is not in¬ frequently obtained in this way, the measure cannot be considered in any way curative, since it does not reach the cause of the malady, and must, in some degree at least, lessen the chances for recovery by low¬ ering the vitality of the patient and especially by impairing the func- THE USE OF DIURETICS. 781 tions, at least when long continued, of so important organs as the kid¬ neys. Abdominal dropsy is very often the result of disease of the liver in which the function of this organ is very greatly impaired. This, of course, very naturally imposes an extra degree of labor on the kidneys, which are obliged to act, in some degree at least, vicariously for the disabled organ. If in this state of things the kidneys are overstimulated by diuretics, it is evident that the result in the long run must be disastrous, since from continued stimulation the kidneys will greatly lose their natural tone, and so become less able to perform the extra labor which is demanded of them. It seems to us that the most rational method, both in this class of cases and the preceding, is to facilitate the function of the kidneys rather than to compel them to do more work without increasing their facility for performing their peculiar functions. In the first class of cases, as already intimated, this may be best accomplished by increas¬ ing the amount of fluid in the blood and thus largely diluting the poi¬ sonous elements which it is the function of the kidneys to separate from the blood, and so rendering the work of elimination easier. In the second class of cases, where superabundant fluid is to be gotten rid of, our experience has been that the work can be much better accom¬ plished, and with far less injury to the system, by increasing the activ¬ ity of the skin than by overstimulating the kidneys. This may be easily done by the use of hot-air baths, Turkish baths, packs, and a great variety of other means of producing increased perspiration. By this means a large portion of the urea which the kidneys usually elim¬ inate will be removed through the skin, and the kidneys will then be able to render the liver much greater aid in the elimination of the poi¬ sons which are usually eliminated by it, but which may also be sepa¬ rated from the blood by the kidneys, and in a slight degree by the skin. Third, in the use of diuretics for the purpose of soothing and di¬ minishing the irritation of the urinary and genital organs, the desired effect is usually obtained almost wholly, if not entirely, from the sim¬ ple dilution of the urine, as already shown. This can be effected bet¬ ter by the copious drinking of water than by any other means, espe¬ cially of very cold water, as elsewhere shown. It ought perhaps to be mentioned also that in cases where the irritation is due to abnormal acidity of the urine this condition may be removed by the regulation of the diet. Fourth, the application of drugs to the genito-urinary organs 782 RATIONAL REMEDIES FOR DISEASE. through the urine is certainly a very roundabout method of medica¬ tion. We have never found difficulty in accomplishing all that was required in the way of local medication by applying the remedies indi¬ cated directly to the organs themselves rather than medicating the whole system before reaching them. Fifth, although great claims have been made for the efficacy of cer¬ tain drugs in preventing the formation of urinary calculi or in dissolving the calculi after they are formed, no satisfactory evidence has yet been offered that any drug possesses properties of this sort. We may per¬ haps make an exception in the case of uric acid deposits, which are, in some degree at least, restricted by the use of potash. Experiments which we have made in cases in which there was a very abundant de¬ posit of uric acid with the use of diet in meeting this condition satisfy us that we can with safety say at least that the use of diuretics is not the only means of accomplishing this result. The conclusion of the whole matter seems to be that of all diuretics pure water is pre-emi¬ nently the most useful, and that by its use, together with the proper regulation of the diet, most of the indications for the use of diuretics can be fulfilled. We have met with many cases in which great harm had resulted from the long-continued use of diuretics, and we are con¬ vinced from observation that the amount of injury thus done is much greater than is generally supposed. Indeed, it is possible that the very extensive employment of diuretics may be one of the causes of the notorious frequency of kidney diseases among the American people. Diaphoretics. — The drugs known by this name are those which excite an increased activity of the skin. In addition to nauseating and refrigerating diaphoretics, the principal employed are jaborandi, spirit of mindererus, siveet spirit of nitre, and alcohol. . Diaphoretics are supposed to produce their effects in four different ways : — First, by relaxation of the blood-vessels of the skin, as from the use of nauseating remedies, such as tartar emetic and ipecacuanha. This result is undoubtedly obtained from the effects of these sub¬ stances upon the nervous system. Any drug which produces nausea may have this result. Relaxation of the circulation in the skin may also be produced in a most effective manner by the employment of either dry or moist heat, as in the hot-air, vapor, Russian, and Turkish baths, together with the warm-water bath and the wet-sheet pack. Second, by diminishing the rapidity of the circulation and thus de- OBJECT OF DIAPHORETICS. creasing the amount of blood passing through the skin. In fever the skin is often so congested that the activity of the perspiratory glands is interfered with, as in congestion of the liver, kidneys, and other excreting organs. Certain drugs, by diminishing the amount of blood circulating in the skin, cause perspiration. These are called re¬ frigerant diaphoretics. Those commonly employed are aconite, vera- trum viride, and the other drugs which have been mentioned as cardiac sedatives. Citrate of potash is often used for this purpose. Third, by directly exciting the action of the perspiratory glands. This is accomplished by means of drugs which are chiefly eliminated by these glands. The action of the perspiratory glands is also power¬ fully excited by means of moist or dry heat as applied by the means already mentioned. Fourth, the activity of the skin may be increased by the copious drinking of pure water or beverages in which it is the chief constitu¬ ent. The diaphoretic effects are best induced by means of warm or hot water. In order to secure free perspiration it is best for the pa¬ tient, after drinking freely, to be covered up warm in bed. The objects to be secured in the use of diaphoretics are, according to the best authorities, substantially as follows : — First, to arrest diseases not very serious in character when just be¬ ginning. This is probably accomplished by causing a flow of blood to the surface, and so relieving internal congestion. The results of checked perspiration and of exposure to cold, such as a general “ cold,” muscular rheumatism, suppressed menstruation, and similar affections, may often be readily relieved in this way. We would suggest that no other means of producing diaphoresis for this purpose is so effect¬ ive as heat combined with copious water-drinking Second, diaphoretics are useful to produce absorption. For this pur¬ pose they are especially employed in dropsy. With reference to the em¬ ployment of diaphoretics. Dr. Wood very truthfully remarks as follows :